Surgically Managed Ovarian Masses at the Royal Children’s Hospital, Melbourne –19 Year Experience
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In brief
In brief
Retrospective analysis of 266 surgically managed ovarian masses in pediatric patients over 19 years at Royal Children's Hospital Melbourne. Study demonstrates shift toward ovarian-sparing cystectomy (increasing from 56% to 94%) with majority of masses being benign, while highlighting diagnostic challenges in detecting malignancy and torsion via ultrasound.
Written by the GCMD Library team from the article.
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