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Hemorrhagic corpus luteum cysts: an unusual problem for pediatric surgeons
C Spinelli1, M Di Giacomo, N Mucci
1Department of Surgery, University of Pisa, Via Roma 67, Pisa 56126, Italy. c.spinelli@dc.med.unipi.it
Insights
Surgically treated hemorrhagic corpus luteum cysts (HCLCs) in pediatric patients showed no complications or recurrence. Conservative surgical approaches are recommended to preserve ovarian function in these cases.
Area of Science:
- Pediatric Surgery
- Gynecologic Oncology
- Reproductive Medicine
Background:
- Hemorrhagic corpus luteum cysts (HCLCs) are common in pediatric patients, particularly after menarche.
- These cysts are often linked to ovulation dysfunction and can necessitate surgical intervention.
Purpose of the Study:
- To evaluate the clinical presentation and surgical outcomes of pediatric patients with HCLCs.
- To assess the safety and efficacy of surgical interventions for HCLCs in girls.
- To determine the long-term impact of surgery on ovarian function and disease recurrence.
Main Methods:
- Retrospective analysis of 13 post-menarcheal girls treated surgically for HCLCs between 2002 and 2006.
- Review of clinical presentation, surgical approach (laparoscopic vs. laparotomic), and post-operative outcomes.
- Follow-up assessments included ultrasound scans and evaluation of menstrual regularity.
Main Results:
- Abdominal pain was the primary symptom in most patients (84.6% persistent, 15.4% acute).
- Ultrasound revealed complex ovarian masses in 77.23% and simple masses in 33.7%.
- While laparoscopic excision was used in over 45% of cases, laparotomy was frequently required. Post-conservative surgery, ovarian function remained normal, with no recurrences at 2-year follow-up.
Conclusions:
- Surgical treatment of HCLCs in pediatric patients is associated with favorable outcomes.
- No complications or disease recurrences were reported following surgical intervention.
- Conservative surgical management is crucial for preserving ovarian function in pediatric HCLC cases.
Study Objective:
Hemorrhagic corpus luteum cysts (HCLC) constitute a common disorder in pediatric subjects undergoing surgical intervention. HCLCs especially develop in the early period after menarche, and they are commonly associated with dysfunctional ovulation.
Design:
Retrospective analysis of surgery outcome of HCLC patients.
Setting:
Pediatric Surgery Unit, S. Chiara University Hospital.
Participant:
13 girls with HCLC diagnosis.
Interventions:
Surgical treatment of HCLCs.
Main Outcome Measures:
We reviewed the clinical presentation and outcome of 13 post-menarcheal girls surgically treated for HCLCs in the Pediatric Surgical Unit from 2002 to 2006.
Results:
Primary presentation was persistent abdominal pain in 84.6% and acute abdominal pain in 15.4% of patients, respectively. Ultrasound examination showed complex ovarian masses in 77.23% cases and simple ovarian masses in 33.7% cases, respectively. Although laparoscopic excision of HCLC was performed in more than 45% cases, laparotomic approach was commonly required. After conservative surgery, ovarian size and viability were normal, as assessed by 6-month ultrasound scan. No recurrences of disease and regular menses were reported at 2 years follow-up.
Conclusions:
In pediatric subjects with HCLC that required surgical intervention, no complications or disorder recurrence were reported. In order to preserve ovarian function, conservative surgery has to be performed whenever feasible.
