Multidisciplinary Management Of Ovarian Tumors In Children And Teens - A Retrospective Study

Ovarian tumors are the main pathology in the genital area among children and teens, their proper management remains a challenge due to the need for a multidisciplinary approach. Aim: The aim of the study was to evaluate the multidisciplinary management of ovarian masses in two reference centers. Material and methods: Files of patients, aged between 0-18 years, diagnosed with an ovarian tumor that required hospitalization between 2008 and 2019, were analyzed retrospectively. The following data were evaluated: demographic aspects, clinical symptoms, used imaging methods, tumor markers, type of treatment, presence of complications and their management, as well as the histological outcomes. Results: The study was performed on 803 patients with a mean age of 13.45 +/- 4.06 years. 339 patients (42.21%) required surgery for tumoral pathology, this being most frequently located in the right side in 521 patients (65%). This surgical treatment was performed by laparoscopy in 55 of the operative cases (16.36%). The main symptom is abdominal pain, 85.42% of diagnosed patients being postmenarch. The most important complication is torsion, found in 22.12% of all ovarian tumors. The primary surgical intervention was cystectomy, which was performed in 53.09% of all surgical cases, in benign pathology, adnexectomy or oophorectomy being preferred in the case of complications or malignant tumors, the latter representing 17.69%. Regarding the histological results, 58.99% were serous cysts, and the main histological type among malignant tumors was represented by dysgerminoma 9.14%. Conclusions: Ovarian tumors in the analyzed age category are mostly benign, being more common in post menarche. The symptoms are nonspecific, dominated by pain in the lower abdominal floor, and the main complication is adnexal torsion. Preservation of fertility is the main goal in the management of ovarian tumors, conservative surgery with ovarian preservation being the main therapeutic concern.