Ovarian masses in pediatric patients: a multicenter study of 98 surgical cases in Tunisia

Abstract

Ovarian masses requiring surgical intervention are uncommon in the pediatric population. Our aim is to report results of a multicentric Tunisian study concerning the clinical practice and the management of pediatric ovarian masses and to identify the factors that are associated with ovarian preservation. Between January 2000 and December 2015, 98 pediatric patients (<14 years) were surgically treated for ovarian masses at the five pediatric surgery departments in Tunisia. Ninety-eight patients were included in this study. The mean age of the patients at time of surgery was 8.46 ± 4.87 years. Sixty-three ovarian masses (64.3%) were non-neoplastic lesions, 24 (24.5%) were benign tumors, and 11 (11.2%) were malignant neoplasms. Conservative surgery (ovarian-preserving surgery) was successfully performed in 72.4% of the benign lesions, whereas only three patients (27.3%) with malignant tumors underwent ovary-sparing tumor resection (p < .001). The mean diameter of the tumors in the patients who underwent oophorectomy was significantly larger than that in the patients who underwent conservative surgery (7.8 ± 3.9 cm vs. 5.7 ± 2.9 cm, respectively, p = .001). In our study, the risk factors for oophorectomy were a malignant pathology and large tumor size. In accordance with the Gynecologic Cancer Intergroup consensus, we recommend that surgical management of ovarian masses in children should be based on ovarian-preserving surgery.

Chinese abstract

儿科人群需要手术干预的卵巢肿物并不常见, 本文将报道一项突尼斯多中心的研究结果, 此项研究致力于儿科患者卵巢肿物的管理及临床治疗, 并找出决定手术能否保留卵巢的相关因素。在2000年1月至2015年12月期间, 在突尼斯的五家儿外科, 98名患者（<14岁）接受手术治疗卵巢肿物。本研究纳入了98名患者, 手术时平均年龄为（8.46 ± 4.87）岁。其中63例卵巢肿物（64.3%）为非肿瘤性病变, 24例（24.5%）为良性肿瘤, 11例（11.2%）为恶性肿瘤。良性卵巢肿瘤的患者中72.4%进行了保守手术（保留卵巢的手术）, 而仅有3例（27.3%）恶性肿瘤患者进行了保留卵巢的肿瘤切除术（p <0.001）。接受卵巢切除术患者的肿瘤平均直径显著大于接受保守手术的患者（分别为7.8 ± 3.9cm与5.7 ± 2.9cm, p = 0.001）。本研究发现, 是否需行卵巢切除术的决定因素为是否病理为恶性及肿瘤大小。根据国际妇科癌症组织的共识, 我们建议小儿卵巢肿物的外科治疗应先以保留卵巢的手术为基础。

Keywords:

• Ovarian masses
• oophorectomy
• conservative surgery
• children

Disclosure statement

No potential conflict of interest was reported by the authors.