Evaluation and Management of Suspected Mucinous Adnexal Masses in Children and Adolescents: A Practice-Focused Review

Suspected mucinous adnexal masses in children and adolescents present a practical management problem rather than a purely diagnostic one. Preoperative classification remains imperfect, large multiloculated cystic masses may prompt unnecessary oophorectomy, and benign final pathology may lead to premature discharge from follow-up. This evidence-informed narrative review begins with the practical preoperative problem of a suspected mucinous mass and uses pediatric benign mucinous cystadenoma (MCA) as the main evidence base for routine decisions, where the most directly applicable pediatric data exist. Mixed pediatric benign ovarian tumor data, pediatric and adolescent borderline ovarian tumor series, adult benign mucinous literature, and pediatric imaging and tumor-marker studies are used mainly to clarify when more aggressive surgical intervention, pathology-based reclassification, or extended follow-up may be needed. The proposed framework is intended for frontline triage and ongoing care of suspected mucinous masses. Using MCA as a starting point rather than a full mucinous neoplastic differential, this review focuses on practical decisions encountered by frontline clinicians: initial triage, ovarian-preserving operative planning, final pathology review, and structured follow-up.