112 Ovarian cysts and masses in childhood and adolescence

Abstract

Objective: To determine the presentation, diagnosis and management of ovarian cysts and masses in children and adolescents. Study design: A retrospective cohort study of children and adolescents with ovarian cysts and masses aged 18 years or younger, presenting to a tertiary referral reproductive medicine unit between 2013 and 2018 was performed. Data were primarily collected using computerized medical notes. The following were noted: age at presentation, diagnostic outcomes, types of management and post-intervention follow up. Results: 60 children or adolescents with ovarian cysts or masses were identified. The median age of diagnosis was 14 years. Seventy-one per cent of patients were post-menarche at presentation. The most common presentation was abdominal pain or discomfort with 49 (82%) patients presenting in this way. Imaging identified 41 (65%) simple cysts, 20 (32%) complex cysts and 2 (3%) ovarian torsions. Three (5%) patients had bilateral cysts. Diagnostic laparoscopy was performed in 10 (17%) patients. Ovarian surgery was performed in 27 (45%) patients, with 9 (33%) patients having an oophorectomy and 20 (74%) being laparoscopic. The commonest diagnoses were mature cystic teratoma and hemorrhagic cyst. Two (3%) malignancies were diagnosed. Follow up within a Pediatric and adolescent gynecology clinic occurred in 30 (50 %) patients. Conclusion(s): This retrospective cohort study demonstrates that the majority of children or adolescents presenting with an ovarian cyst or mass present post-menarche. Most patients had a benign cyst, commonly a mature cystic teratoma or hemorrhagic cyst, and were treated conservatively or with minimal access ovary-sparing surgery.