Management of ovarian dermoid cysts in the pediatric and adolescent population
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Updated: Jun 21, 2026
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Published on: January 22, 2022
Ingrid Savasi1, Judith A Lacy, J Ted Gerstle
1University of Toronto, Hospital for Sick Children, Toronto, Canada.
Insights
Laparoscopic cystectomy is a safe and effective surgical approach for pediatric and adolescent ovarian dermoid cysts. This method offers a shorter hospital stay compared to laparotomy, despite a higher rate of intraoperative cyst rupture.
Area of Science:
- Pediatric Surgery
- Gynecologic Oncology
- Minimally Invasive Surgery
Background:
- Ovarian dermoid cysts are common germ cell tumors in pediatric and adolescent females.
- Surgical management aims for cyst excision while preserving ovarian function.
- The choice of surgical approach impacts patient outcomes.
Purpose of the Study:
- To evaluate and compare surgical approaches for ovarian dermoid cyst management in young patients.
- To assess the safety and efficacy of laparoscopy versus laparotomy.
- To identify factors influencing surgical outcomes.
Main Methods:
- Retrospective chart review of 41 pediatric and adolescent patients.
- Data collected from January 2001 to January 2006.
- Comparison of laparoscopic versus laparotomy cystectomy outcomes, including rupture rates, hospital stay, and complications.
Main Results:
- Laparoscopic cystectomy was performed in 56% of cases, laparotomy in 34%, and oophorectomy via laparotomy in 10%.
- Cyst size was significantly larger in the laparotomy group (14.4 cm) vs. laparoscopy group (7.1 cm).
- Laparoscopic surgery had a 100% intraoperative cyst rupture rate versus 27.7% for laparotomy (P < .001), with shorter hospital stays (0 vs. 3 days, P < .001).
- One patient in the laparoscopy group experienced a bladder injury and necrotizing fasciitis.
Conclusions:
- Laparoscopic cystectomy is a safe and effective surgical option for pediatric and adolescent ovarian dermoid cysts.
- Despite higher rupture rates, laparoscopy offers benefits like reduced hospital stay.
- Careful patient selection and surgical technique are crucial for optimal outcomes.
Study Objective:
To evaluate the surgical approach used in the management of ovarian dermoid cysts in the pediatric and adolescent population.
Design:
A descriptive retrospective chart review of all cases of ovarian dermoid cyst excision between January 2001 and January 2006.
Setting:
The Hospital for Sick Children, Toronto, Canada.
Participants:
Forty-one female children and adolescents who underwent operative management of an ovarian dermoid cyst.
Main Outcome Measures:
Surgical approach (laparoscopy vs laparotomy), intraoperative cyst rupture, length of hospital stay, and postoperative complications.
Results:
The mean age was 12.5 years. All cysts were unilateral. Twenty-three patients (56%) underwent laparoscopic cystectomy, 14 (34%) underwent cystectomy via laparotomy, and 4 (10%) oophorectomies were performed via laparotomy. Cyst size was significantly larger in the laparotomy group compared to the laparoscopy group (mean diameter 14.4 cm vs 7.1 cm, respectively, P < .001). A significantly higher rate of cyst rupture was experienced during laparoscopic cystectomy (100%), compared to excision via laparotomy (27.7%, P < .001). Length of hospital stay was significantly shorter in the laparoscopy group compared to the laparotomy group (median of 0 vs 3 days, respectively, P < .001). A single case in the laparoscopy group sustained a bladder injury and developed postoperative necrotizing fasciitis resulting in a prolonged hospitalization and recovery. There were no operative or postoperative complications related to cyst content spillage, regardless of the surgical approach.
Conclusion:
Laparoscopic cystectomy is a safe and effective method of managing ovarian dermoid cysts in the pediatric and adolescent patient population.
