Evaluation, management and aotcome of paediatric ovarian lesions: 67 consecutive patients surgically treated in 7 year period.

Abstract: diagnosis in any female who presents abdominal pain, a pelvic or abdominal mass, or an endocrinologic disorder. The aim of this report is to describe our strategy of care for patients with suspected ovarian lesions. We performed a retrospective chart review, and analyzed the clinical onset, the diagnostic work-up, the surgical procedure, and the outcome of all patients treated surgically for ovarian lesions at the "Azienda Ospedaliera Universitaria Pisana", between 2000 and 2006. Sixty-seven patients with a mean age of 16 years (range: 6 months to 18 years) had 72 ovarian lesions (five cases were bilateral). Abdominal pain was the most common presenting symptom. All patients underwent trans-abdominal ultrasound (US), 40% had trans-vaginal ultrasound, and 21% had either abdominal computed tomography (CT) or magnetic resonance image (MRI). Conservative surgery was performed in the majority of cases (58%) to preserve fertility. Thirty-eight lesions (53 %) were non-neoplastic ones, 31 were benign tumors (43 %) and only 3 were malignant (5.4%). The most common ovarian lesions were functional cysts (30%) and mature cystic teratomas (26%). All patients except for one (who had a yolk sac tumor) are currently disease- free. Ovarian lesions are a rare indication for surgery in pediatric patients, in which the incidence is estimated to be around 2.6 cases per 100.000 females per year. As most of these lesions are benign, ovarian-preserving techniques should be performed when feasible to minimize the risk of decreased fertility and endocrine function.