Analysis Of Clinicopathological Characteristics And Treatment Strategy Of Ovarian Masses In Children And Adolescents

Background&ObjectiveChildren and adolescents girls rarely take physical examination because of their special age and the ovarian masses also lack of the specific clinical manifestations. So the diagnosis of children and adolescents ovarian masses is easily overlooked. How to diagnose and treat correctly and timely, for preserving ovarian tissue and reproductive function and reducing the complications of patients, are particularly important to the children and adolescents girls. This study analysis the clinicopathological characteristics of ovarian masses in children and adolescents, explore the rational treatment strategy.MethodsThere were196children and adolescents who underwent treatment at Qilu Hospital of ShanDong University between April2005and April2013. The data collected from hospital medical records were reviewed retrospectively regarding age, presentation, diagnosis, treatment, and outcome. Preoperative diagnostic approach included history, physical examination, ultrasonography, radiological examination, tumor markers, operative treatment, and histopathological examination of the tumor. Chemotherapy was given where indicated.ResultsThe most common presenting symptom was abdominal pain (n=111,56.63%), followed by menstrual changes (n=34,17.35%) and incidental finding (n=21, 10.71%).195patients received surgery and176patients had benign tumors (90.26%). The most common pathological type were germ cell tumors (n=90,46.15%), of which mature teratoma accounted for40.51%(n=79), immature teratoma and yolk sac tumor accounted for5.64%(n=11). Followed by non-neoplastic lesions (n=64,32.82%) and ovarian epithelial tumor (n=34,17.44%). All patients underwent fertility sparing operation and most of malignant tumor girls received combination chemotherapy. Postoperative follow-up rate was85.71%(n=168).Conclusions1Ovarian masses in children and adolescents lack of specific clinical manifestations.2Regular ultrasonography and detection of tumor markers are helpful to improve the early diagnosis.3Most of these lesions are benign, so ovarian-preserving operations should be performed whenever feasible.4Treatment of malignant tumors would involve complete staging, resection of the tumor, postoperative chemotherapy when indicated, to provide more future childbearing chances.