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Paratubal Cyst Recurrence in Children and Adolescents
Leila Magistrado1, Julie Dorland2, Haleh Sangi-Haghpeykar3
1Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas; Division of Pediatric and Adolescent Gynecology, Baylor College of Medicine, Houston, Texas; Department of Pediatrics, Texas Children's Hospital, Houston, Texas.
Insights
Paratubal cysts (PTC) in children have an 11.3% recurrence rate, often on the same side. Patient characteristics like BMI or PCOS do not predict recurrence risk.
Area of Science:
- Pediatric Surgery
- Gynecologic Oncology
- Reproductive Health
Background:
- Paratubal cysts (PTC) are common adnexal masses in pediatric and adolescent females.
- Understanding recurrence patterns is crucial for patient counseling and management.
- Limited data exists on risk factors associated with PTC recurrence in this age group.
Purpose of the Study:
- To investigate patient characteristics associated with the risk of paratubal cyst recurrence in children and adolescents.
- To identify potential predictors of recurrence for improved clinical management.
Main Methods:
- Retrospective chart review of pediatric patients diagnosed with PTC between 2007 and 2019 at a single academic children's hospital.
- Data collected included age, ethnicity, BMI, PCOS diagnosis, cyst size, laterality, number of cysts, and recurrence status.
- Statistical analysis to compare characteristics between patients with and without recurrent PTC.
Main Results:
- 11.3% of 627 eligible patients experienced PTC recurrence.
- No significant differences were found in age, BMI, ethnicity, PCOS, cyst size, laterality, or number of cysts between recurrent and non-recurrent groups.
- The majority of recurrences (70.1%) occurred on the ipsilateral side.
- PTC Not Otherwise Specified (NOS) and serous PTC were the most frequent pathologies.
Conclusions:
- A baseline recurrence risk for paratubal cysts exists in pediatric patients.
- Recurrence is not significantly associated with specific patient characteristics, cyst factors, or pathology types.
- Recurrences are more likely to occur on the same side as the original cyst.
Study Objective:
To examine the association between patient characteristics and risk for recurrence risk of paratubal cysts (PTC) in children and adolescents.
Design:
Retrospective chart review at a single institution.
Setting:
Single academic children's hospital.
Participants:
Pediatric patients presenting to Texas Children's Hospital between July 2007 and March 2019. Patients were identified for the study by reviewing pathology reports and were included if they met inclusion criteria of a pathologic diagnosis of a paratubal or paraovarian cyst removed during any surgical procedure between July 2007 and March 2019.
Interventions:
Subjects with pathologic diagnoses of a paratubal cyst during the study period underwent chart review for the following data points: age at presentation, ethnicity, pathologic recurrence of paratubal cysts, pubertal status, body mass index (BMI), diagnosis of polycystic ovary syndrome (PCOS), size of cyst, laterality of cysts, and number of cysts.
Main Outcome Measure(S):
Recurrence, Pathology types.
Results:
Of the 627 patients that met inclusion criteria, the incidence of recurrence was 11.3%. Group 1 included those with recurrence of PTC (N = 70). Group 2 was identified as those without recurrence of PTC (N = 557). There were no differences related to age, BMI, ethnicity, history of PCOS, cyst size, laterality or number of cysts present. PTC NOS and serous PTC occurred most frequently. Of the unique cases involving recurrence, 70.1% recurred on the ipsilateral side. There were no cases of paratubal cyst malignancies in this cohort. The range of pathology diagnoses included pathologies that may occur in ovarian cysts. This is particularly interesting, given the known origins of ovarian cancer from fallopian tube transformations. Rare pathology diagnoses likely did not occur with frequency to determine definitive risks of recurrence in these cases.
Conclusions:
There appears to be a baseline recurrence risk for PTC, for which patients can be counseled. Recurrence does not appear to be associated with any particular pathology type, cyst size, number of cysts, BMI, PCOS, or puberty stage. Recurrence, should it occur, appears to occur more commonly on the ipsilateral side.
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