Surgical management of ovarian teratomas in childhood: a multicentric study on 110 cases and a literature review

Abstract

Aim of the study

To compare a multicentric surgical experience on ovarian teratomas in childhood with the current management trends.

Design

A retrospective multicentric pediatric ovarian teratomas surgically treated between January 2000 and August 2020 at four Italian institutions. PubMed database was used to search for Reviews and Systematic Reviews published between January 2010 and August 2020: 15 manuscripts reported 3633 ovarian neoplasms in pediatric age, 1219 (33,5%) of which were ovarian teratomas.

Results

A hundred-ten patients with a mean age at diagnosis of 11.8 years were enrolled. Mature cystic teratomas accounted for the 90% of the masses. At surgery, 78 were oophorectomies and 32 were ovary sparing surgeries. Laparoscopy occurred in 16.3% of the surgeries.

As regarding the current management trends, the mean age at diagnosis was 11.9 years and 80.5% of the cases were represented by mature teratomas. Of 430 procedures, 331 were oophorectomies while 99 were ovary sparing surgeries and laparoscopy was performed in 23.8% of cases.

Conclusions

Ovary-sparing surgery with laparoscopic approach is increasingly offered as standard treatment for benign masses that fit the criteria for mature teratomas, in the attempt to achieve the best compromise between the preservation of fertility and the prevention of recurrences. Awareness should be raised among pediatric surgeons to reduce unnecessary radical surgery.

儿童卵巢畸胎瘤的外科治疗：110例多中心研究及文献综述 摘要

研究目的：比较儿童卵巢畸胎瘤多中心手术经验的管理现状。

设计：回顾性多中心研究2000年1月至2020年8月间在四家意大利医疗机构进行手术治疗的儿童卵巢畸胎瘤患者。PubMed数据库用于检索2010年1月至2020年8月之间发表的综述和系统性综述：15篇文献报道了3633例儿童卵巢肿瘤患者, 其中1219例（33.5%）为卵巢畸胎瘤。

结果：研究纳入110例患者, 平均诊断时年龄11.8岁。成熟囊性畸胎瘤占90%。78例行卵巢切除术, 32例行保留卵巢手术。进行腹腔镜手术率为16.3%。

结果：根据目前的诊疗现状, 平均诊断时年龄为11.9岁, 80.5%的病例为成熟畸胎瘤。在430例手术中, 331例行卵巢切除术, 99例行保留卵巢手术, 23.8%的病例进行了腹腔镜检查。

结论：腹腔镜保留卵巢手术越来越多地被作为符合成熟畸胎瘤诊断标准的良性肿瘤的标准治疗方法, 旨在保留生育能力和防止复发之间达成最佳折衷。应提高儿科外科医生的认识, 减少不必要的根治性手术。

Keywords:

• Ovarian teratoma
• ovary-sparing surgery
• pediatrics
• adolescents

Disclosure statement

All the authors declare that they have no conflicts of interest.