Ovarian masses in infant-juvenile age
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Updated: Feb 10, 2026

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Published on: June 9, 2023
Kaan Sonmez1, Zafer Turkyilmaz2, Ramazan Karabulut2
1Gazi University, Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey. karabulutr@yahoo.com.
Insights
Pediatric ovarian lesions are often functional or torsion-related, with malignancy being rare. Ovarian protective surgery is recommended for children, prioritizing ovarian preservation in surgical treatment.
Area of Science:
- Pediatric Surgery
- Gynecologic Oncology
- Ovarian Pathology
Background:
- Surgical treatment for pediatric ovarian lesions varies, with ovarian preservation being a key goal in children.
- Understanding the characteristics and optimal management of these lesions is crucial for pediatric surgical outcomes.
Purpose of the Study:
- To analyze findings from pediatric patients undergoing surgery for ovarian lesions.
- To compare different types of ovarian pathologies in children regarding clinical presentation and surgical approach.
Main Methods:
- A 13-year retrospective study of 56 patients under 17 years old.
- Patients were categorized into functional (cysts, torsion), epithelial ovarian lesions, and germ cell tumors groups.
- Data analyzed included age, symptoms, torsion, mass size, and surgical procedure (salpingo-oophorectomy vs. cyst excision).
Main Results:
- Functional lesions (cysts, torsion) were most common, followed by epithelial tumors and germ cell tumors.
- Abdominal-pelvic pain (85.7%) and swelling (37.5%) were the most frequent symptoms.
- Torsion occurred in 37.5% of cases; cyst excision was more common for functional lesions, while salpingo-oophorectomy was more frequent for epithelial and germ cell tumors.
Conclusions:
- Functional ovarian pathologies and torsion are prevalent in premenarcheal pediatric patients.
- Malignant ovarian lesions are rare across all age groups in this cohort.
- Ovarian-protective surgical techniques should be prioritized in the management of pediatric ovarian lesions.
Introduction:
The appropraite surgical treatment to pediatric patients with ovarian lesions are heterogeneous and ovarian preservation is desirable in children. The aim of this study is to the discuss findings related to a set of patients who were operated on for ovarian lesions.
Patients And Methods:
A retrospective study carried out in 13 years on 56 patients under the age of 17. These patients were divided into 3 groups according to ovarian pathologic diagnosis: 25 with functional (cyts and torsion), 18 with epithelial ovarian lesions and 13 with germ cell tumours. These three groups were compared in terms of menarche, torsion, age, duration, size, pain, mass, vomiting, irregular menstruation, location and operation type.
Results:
Follicle cysts, serous cyst adenomas and teratomas were the most common in these groups. The mean age of the patients was 12.18±4.84 years. The most common symptoms and signs were abdominal-pelvic pain (85.7%) and swelling(37.5%). Torsion was seen in 21 patients (37.5%), mean mass size was found to be 10.46±6.55 cm. A salpingo-oophorectomy (SO) was performed in 38 patients and cyst excision (CE) was performed in 18 patients. In premenarcheal cases, torsion was seen more in menarcheal cases and in the functional lesion group. CE was performed more often in the functional and t SO was performed often in the epithelial and germ cells groups.
Conclusion:
Torsion and functional ovarian pathologies are thought to be common in premenstrual ages and malign lesions are very rare in all age groups so we recommend ovarian protective surgery should be preferred.
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