Management of ovarian cysts in children and adolescents

Abstract

Key content Most ovarian cysts in children and adolescents are benign. Incidence of large ovarian cysts usually peaks in the first year of life and around menarche; approximately 30% of girls will present with pain. Gynaecologists, paediatric surgeons and general surgeons may manage ovarian cysts. There is a lack of standardised protocols and guidance, so most patients are managed on the basis of an individual clinician’s judgement, preference and experience. Whenever possible, the operation of choice for benign cysts is laparoscopic ovarian cystectomy with ovarian preservation. This review provides an evidence‐based tool for the management of ovarian cysts in children and adolescent girls. Learning objectives To identify ovarian pathology using appropriate imaging in emergency and elective situations. To know that, when possible, a multidisciplinary approach between gynaecologists, radiologists and paediatric surgeons is optimal. To be vigilant for malignant tumours and perform ovarian‐sparing surgery for suspected benign conditions. Ethical issues There are long‐term reproductive consequences of inadvertently removing one or both ovaries. Unnecessary surgery has an effect on patients’ physical and mental wellbeing.