DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150102

Adolescent ovarian tumours: a gynecologist’s dilemma

Shreedevi Tanksale, Kirti Bendre, Geeta Niyogi

Abstract


Background: Objective: To review the clinical presentation and outcome of ovarian tumours in children and adolescents upto 20 years of age, who presented at K. J. Somaiya Hospital and Medical research centre.

Methods: The study was carried out in the Ob/Gyn department at K. J. Somaiya Hospital and Medical research centre between 2006 and 2012 after approval from the ethical committee. The data of the patients regarding age, presentation, diagnosis, investigations, treatment, and outcome was reviewed and analysed.

Results: There were 32 patients between 13 and 20 years of age who presented with an ovarian tumour during the study period. Majority of the patients belonged to age group 17-19 years. The main presenting symptom was pain in abdomen in 21 (65%) patients. Operative procedures included 18 (56%) exploratory laparotomies and 14 (44%) operative laparoscopies. Ovarian cystectomy was done in 23 (71%) patients, unilateral oophorectomy in 3 (9%) patients, bilateral oophorectomy with omentectomy in 1 (3%) patient and salpingoophorectomy in 1 (3%) patient. Histopathology reports showed 2 cases each of serous cystadenoma, mucinous cystadenoma and dermoid cyst and one case of dysgerminoma. Corpus lutueal cyst was most common cyst found on histopathology.  

Conclusions: Early correct diagnosis of ovarian masses in young girls is important and can be reached by careful physical examination, imaging and tumour markers. Surgery should be as much as possible for fertility preservation. The treatment of malignant tumors would involve complete staging, resection of the tumor, postoperative chemotherapy when indicated, to give the patient a chance for future childbearing. 


Keywords


Ovarian mass, Adolescent

Full Text:

PDF

References


Skinner MA, Schlatter MG, Heifetz SA, Grosfeld JL. Ovarian neoplasms in children. Arch Surg. 1993;128:849.

Warner BW, Kuhn JC, Barr LL. Conservative management of large ovarian cysts in children: the value of serial pelvic ultrasonography. Surgery. 1992;112:749.

Kozlowski KJ. Ovarian masses. Adolesc Med. 1999;10:337-50.

Millingos S, Protopapas A, Drakakis P, Liapi A, Loutradis D, Rodolakis A, et al. Laparoscopic treatment of ovarian dermoid cysts: eleven years’ experience. J Am Assoc Gynecol Laparosc. 2004;11:478.

Vaisbuch E, Dgani R, Ben-Arie A, Hagay Z. The role of laparoscopy in ovarian tumors of low malignant potential and early-stage ovarian cancer. Obstet Gynecol Surv. 2005;60:326.

Von Allmen D. Malignant lesions of the ovary in childhood. Semin Pediatr Surg. 2005;14:100.

DePriest PD, Varner E, Powell J, Fried A, Puls L, Higgins R. The efficacy of a sonographic morphology index in identifying ovarian cancer: a multi institutional investigation. Gynecol Oncol. 1994;55:174-8.

Breen J, Maxon WS. Ovarian tumours in childhood and adolescence. Clin Obstet Gynecol. 1977;20:607-23.

Baloch S, Khaskheli M, Malik AM, Sheeba A, Khushk IA. Clinical spectrum and management of ovarian tumours in young girls upto 20 years of age. J Ayub Med Coll Abbottabad. 2008;20(4):14-7.

Amatya A, Rana G, Gurung L. Ovarian tumours in childhood and adolescents - our eight years experiences. Nepal J Obstet Gynaecol (NJOG). 2008 May-June;3(1):39-42.

Choudry A, Bangash N, Malik A, Choudry H. Adolescent ovarian tumors: a clinicopathlogical review of 15 cases. J Ayub Med Coll Abbottabad. 2008 Oct-Dec;20(4):18-21.

Pansky, M, Abargil, A, Dreazen, E, Golan A, Bukovsky I, Herman A. Conservative management of adnexal torsion in premenarchal girls. J Am Assoc Gynecol Laparosc. 2000;7:121-4.

Goldstein DP, deCholnoky C, Emans SJ, Leventhal JM. Laparoscopy in the diagnosis and management of pelvic pain in adolescents. J Reprod Med. 1980;24:251-6.

Rosen DM, Lam AM, Carlton MA, Cario GM. The safety of laparoscopic treatment for ovarian dermoid tumours. Aust NZ J Obstet Gynaecol. 1998;38:77-9.

Luxman D, Cohen JR, David MP. Laparoscopic conservative removal of ovarian dermoid cysts. J Am Assoc Gynecol Laparosc. 1996;3:409-11.

Lin P, Falcone T, Tulandi T. Excision of ovarian dermoid cysts by laparoscopy and by laparotomy. IS J Obstet Gynecol. 1995;173:769-71.