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Ovarian cysts and tumours in infancy and childhood
Insights
Ovarian cysts and tumors in children are common, with most being benign. Dysgerminomas are the most frequent malignant ovarian tumors in pre-menarchal girls, but prognosis is often good.
Area of Science:
- Pediatric Surgery
- Gynecologic Oncology
- Pediatric Radiology
Background:
- Ovarian cysts and tumors occur in children, with a significant proportion presenting before menarche.
- Historically, surgical intervention was the primary approach for diagnosis and treatment.
- Diagnostic challenges exist, particularly for pre-pubertal ovarian lesions.
Purpose of the Study:
- To review the presentation, pathology, and diagnostic challenges of pre-menarchal ovarian lesions.
- To evaluate the role of ultrasound in diagnosing childhood ovarian masses.
- To assess the outcomes of malignant ovarian tumors in children.
Main Methods:
- Retrospective review of 106 pediatric patients operated on for ovarian masses between 1950 and 1982.
- Analysis of patient demographics, clinical presentation, surgical findings, pathology, and treatment outcomes.
- Evaluation of the diagnostic utility of ultrasound in recent cases.
Main Results:
- 71 of 106 patients were pre-menarchal.
- Most ovarian masses in children are benign.
- Dysgerminomas were the most common malignant ovarian tumors encountered.
- Ultrasound demonstrated increasing diagnostic value.
- Prognosis for dysgerminomas remained reasonably good, even with tumor spread.
Conclusions:
- Pre-menarchal ovarian masses require careful evaluation due to potential for malignancy.
- Ultrasound is a valuable tool for the diagnosis of pediatric ovarian masses.
- Despite the risk of malignancy, outcomes for childhood ovarian tumors, including dysgerminomas, can be favorable with appropriate management.
Abstract:
Cysts and tumours of the ovary are not uncommon in childhood. In 33 years between 1950 and 1982 106 patients were operated on at Alder Hey Children's Hospital and the Royal Liverpool Children's Hospital. Of these 71 were pre-menarchal. The mode of presentation, pathology and diagnostic difficulties of the pre-menarchal lesions are reviewed. The value of ultrasound scanning has become apparent in recent years. Most cysts and tumours are benign, but dysgerminomas are the most common malignant tumours encountered. Even when there is evidence of spread of the tumour the prognosis in these remains reasonably good.