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Diagnosis and treatment of ovarian cysts in children
1Department of Paediatric Surgery, University Hospital, Lund, Sweden.
Insights
Ovarian cysts in girls can be managed conservatively if asymptomatic and small. Surgery is recommended for complicated, large, or symptomatic ovarian cysts, prioritizing ovarian tissue preservation.
Area of Science:
- Pediatric Surgery
- Gynecologic Oncology
- Neonatal Medicine
Background:
- Ovarian cysts are common in pediatric patients.
- Presentation varies significantly between neonates and older children.
Purpose of the Study:
- To review the management and surgical outcomes of ovarian cysts in pediatric patients.
- To establish criteria for conservative versus surgical management.
Main Methods:
- Retrospective review of 17 girls diagnosed with ovarian cysts.
- Analysis of patient demographics, symptoms, diagnostic methods, surgical procedures, and outcomes.
Main Results:
- 16 of 17 patients underwent surgery, with indications including complicated cysts in infants and suspected appendicitis in older girls.
- Surgical procedures varied, including cyst uncapping and oophorectomy.
- Conservative management is suggested for asymptomatic, small ( < 4 cm) ovarian cysts in infants.
Conclusions:
- Ovarian cyst management in girls requires individualized assessment.
- Surgery is indicated for symptomatic or complicated ovarian cysts.
- Conservative management is appropriate for select asymptomatic cases, with close ultrasound monitoring.
Abstract:
Seventeen girls were treated following the diagnosis of ovarian cysts. Four patients were operated on within the first 6 months of age and the other 13 patients were 10-15 years old at the time of diagnosis. Antenatal diagnosis was made in 3 cases. The presenting symptoms in the infants were distended abdomen in 3 cases, abdominal pain in 1 and vomiting in 1. In the older children the presenting symptoms were abdominal pain in 12, vomiting in 5 and elevated temperature in 6. Preoperative ultrasound was performed in 5 patients, 3 neonates and 2 older children. Sixteen of the 17 girls were operated on. The indication for surgery was an ovarian cyst with complication in the infants and in the older children the suspicion of acute appendicitis. The operative procedure was cyst uncapping in 7 cases, salpingo-oophorectomy in 4, ovarian resection in 2, ovarian fixation only in 1 and no ovarian intervention in 2. Asymptomatic infants with an ovarian cyst less than 4 cm in diameter can be managed conservatively. Surgery can be recommended after documented change of the cyst on ultrasound, large cysts giving rise to symptoms or presentation of an acute abdomen. Salvage of variable ovarian tissue is desirable.