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. 

Abstract

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.