Massive ovarian edema in the pediatric patient: a rare solid tumor

Solid ovarian masses in children are considered malignant unit proven otherwise. The authors report two cases of an unusual, benign, solid ovarian tumor found during ultrasound examination for evaluation of acute abdominal pain. Both patients were found to have a torsed nonviable ovary at the time of laparotomy. Patient 1 was a premenarcheal 10 year old who had undergone a lengthy evaluation for intermittent chronic abdominal pain. The ultrasound examination showed a 9- x 5-cm ovarian mass. Patient 2 was a virilized menarcheal 11 year old with a very large tumor (10 x 7 x 16 cm). The final pathology for both tumors was massive ovarian edema--a rare, stromal, virilizing tumor caused by chronic venous and lymphatic obstruction. Contralateral oophoropexy is a controversial treatment for the remaining ovary. A review of the literature regarding this uncommon tumor is provided.