Abstract

Adolescence starts with the beginning of physiologically normal puberty, and ends when an adult identity and behavior are admitted. This period of development corresponds roughly to the period between the ages of 10 and 19 years, which is compatible the World Health Organization’s definition of adolescence. Most of the adnexal masses during this period are functional ovarian cysts and benign neoplasms, and conservative surgery is suggested in the case of a cystic mass smaller than 8 cm. In all adolescents with adnexal masses, the preoperative evaluation should include a comprehensive medical record, physical examination, and imaging methods such as ultrasonography and laboratory examinations. The aim of this study was to evaluate preoperative findings, surgical procedure and histopathologic findings of the adolescent patients who had surgery for adnexal mass in our clinic. Totally 41 patients were included into study. Age, menstrual history, complaints during admission, images of the masses that were detected with different modalities, laboratory findings, applied surgical procedure and pathology findings were recorded. Among the symptoms that lead patients to admit hospital, abdominal pain was the first that was in 23 patients (56.1%). As we evaluate type of operation, 12 patients (29.3%) had laparoscopy, 29 patients (70.7%) had exploratory laparotomy operation. Mini laparotomy was the most often used incision type in 17 patients (41.5%). 34 patients (82.9%) had only cystectomy as an organ preserving surgery and most common histopathologic diagnosis was functional cyst in 14 patients (34.1%). In conclusion; since most pelvic masses in the adolescent period have benign character, surgery in this period should be minimally invasive and organ preserving for future fertility concerns and avoid from premature menopause.

Highlights

  • Adnexal masses may result from benign or malignant lesions of ovarian, tubal, and paratubal origin, as well as pregnancy-related causes such as Mullerian anomalies, infectious causes, and ectopic pregnancy [1,2]

  • Surgical intervention was separated into two groups, namely, exploratory laparotomy and laparoscopy, while exploratory laparotomy was categorized in itself as minilaparotomy, classic laparotomy and median incision by means of transverse incision

  • cancer antigen-125 (Ca-125), one of the pre-operative tumor markers, was significantly high in 17 patients (41.5%), whereas AFP and human chorionic gonadotropin (hCG) levels were normal in all patients

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Summary

Introduction

Adnexal masses may result from benign or malignant lesions of ovarian, tubal, and paratubal origin, as well as pregnancy-related causes such as Mullerian anomalies, infectious causes, and ectopic pregnancy [1,2]. In all adolescents with adnexal masses, the preoperative evaluation should include a comprehensive medical record, physical examination, and imaging methods such as ultrasonography (USG) and laboratory examinations [3,4,5]. The incidence of adnexal masses that require surgery is low, since functional cyst and benign neoplasms are most frequently seen in the adolescence period [6,7,8]. The current study aimed to analyze the pathological results of preoperative findings, surgical methods, and excised materials in adolescent girls operated on in our clinic for adnexal masses. Surgical intervention was separated into two groups, namely, exploratory laparotomy and laparoscopy, while exploratory laparotomy was categorized in itself as minilaparotomy, classic laparotomy and median incision by means of transverse incision. The surgical treatment was recorded as cystectomy, salpingo - oophorectomy (SOO), SOO - staging surgery and adnexal detorsion - cystectomy

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