WH&Y authors: Doctor Jennifer Marino
Citation: How JA, Marino JL, Grover S, Heloury Y, Sullivan M, Mellor A, McNally O, Jayasinghe Y. 2019. Surgically managed ovarian masses at the Royal Children's Hospital, Melbourne - 19 year experience. Journal of Pediatric Surgery 54(9): 1913-20.
Background/Purpose: To describe the clinicopathological characteristics and management of surgically removed ovarian masses at the Royal Children’s Hospital, Melbourne from 1993 to 2012.
Methods: Medical records were reviewed retrospectively. Data regarding clinical findings, imaging and surgical management were evaluated.
Results: There were 266 ovarian masses found in 258 surgeries (eight had bilateral masses). Most were benign (246/266, 92.5%), 2.3% (6/266) were borderline, and 5.3% (14/266) were malignant. The most common presenting symptom was abdominal pain for benign masses (169/246, 68.7%), and a palpable mass for borderline and malignant masses (12/20, 60.0%). Sensitivity and specificity of ultrasound for detection of malignancy was 64.7% and 52.9% respectively. Ovarian torsion occurred in 22.1% (n = 57), none with malignancy, with seven cases diagnosed under one year of age. Sensitivity and specificity of ultrasound for ovarian torsion was 22.0% and 91.9%, respectively. The proportion undergoing ovarian cystectomy rather than oophorectomy has increased from 56.3% during 1993-1997 to 93.8% during 2008-2012 (p < 0.005). Ovarian torsion was managed with ovarian conservation in 82.6% of cases between 2008-2012.
Conclusion: The majority of pediatric and adolescent ovarian masses were benign. Sensitivity of ultrasound was fair for detection of malignancy, and poor for ovarian torsion. Conservative surgeries are increasingly common.
About The Authors
Dr Jennifer Marino is a Senior Research Fellow in the Department of Obstetrics and Gynaecology at th...