Ovarian masses in the child and adolescent

Over a five-year period, we treated 16 children ranging in age from 8 weeks to 16 years for ovarian masses. The most frequent clinical manifestation was abdominal pain and/or mass. Ultrasonography correctly localized the lesion and delineated its nature in nine of ten cases. Operation in 15 showed teratoma (six benign, two malignant), endodermal sinus tumor (two), dysgerminoma (two), follicular cyst (two), and leukemic ovarian infiltrate (one). Adnexal torsion was present in three. Three children had tumor metastases at initial operation. Resection of the tumor with conscious preservation of uninvolved pelvic structures was performed if possible. For unresectable tumor, debulking was undertaken. Multiagent chemotherapy was used for all malignant tumors. Survival was 94%. The proper therapy for ovarian lesions in children requires familiarity with the unique nature of these lesions, as well as consideration of future endocrine and reproductive function.