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Challenging the size: ovarian-sparing surgery in borderline huge pediatric ovarian tumors
Aurora Mariani1,2, Venusia Fiorenza3, Frédéric Hameury4
1Department of Pediatric Surgery, Angers University Hospital, Angers, France. auroramariani@hotmail.it.
Objective:
Huge ovarian tumors in paediatric patients pose a surgical challenge, particularly in distinguishing tumor margins from ovarian parenchyma. While ovarian preservation is recommended for benign masses, concerns about tumor size may limit its application. This study evaluates the feasibility and outcomes of ovarian-sparing surgery (OSS) in children with giant ovarian tumors.
Materials And Methods:
A retrospective study was realize on girls (< 18 years) who underwent surgery for ovarian masses with cystic lesions ≥ 8 cm in our department (2009-2019). We included all patients classified O-RADS 3 and 4, and excluded O-RADS 5 in those OSS is contraindicated. Data on clinical presentation, imaging, tumor characteristics, surgical approach, histopathology, and follow-up were collected. Patients were categorized into two groups: OSS and oophorectomy (OV).
Results:
Thirty patients (mean age: 13 years, range 3-17) were treated, including one with bilateral tumors. Palpable abdominal mass was the most common symptom (33.3%). The median tumor diameter was 148 mm (range 80-350 mm); 16 were purely cystic, 15 had mixed components, and 4 had calcifications. Tumor markers were negative except in 2 cases. Histology confirmed all tumors were benign (17 teratomas, 12 cystadenomas, 2 functional cysts).
