Adolescent ovarian tumours: a gynecologist's dilemma

Abstract

Background: Objective: To review the clinical presentation and outcome of ovarian tumours in children and adolescents upto 20 years of age, who presented at K. J. Somaiya Hospital and Medical research centre.Methods: The study was carried out in the Ob/Gyn department at K. J. Somaiya Hospital and Medical research centre between 2006 and 2012 after approval from the ethical committee. The data of the patients regarding age, presentation, diagnosis, investigations, treatment, and outcome was reviewed and analysed.Results: There were 32 patients between 13 and 20 years of age who presented with an ovarian tumour during the study period. Majority of the patients belonged to age group 17-19 years. The main presenting symptom was pain in abdomen in 21 (65%) patients. Operative procedures included 18 (56%) exploratory laparotomies and 14 (44%) operative laparoscopies. Ovarian cystectomy was done in 23 (71%) patients, unilateral oophorectomy in 3 (9%) patients, bilateral oophorectomy with omentectomy in 1 (3%) patient and salpingoophorectomy in 1 (3%) patient. Histopathology reports showed 2 cases each of serous cystadenoma, mucinous cystadenoma and dermoid cyst and one case of dysgerminoma. Corpus lutueal cyst was most common cyst found on histopathology.  Conclusions: Early correct diagnosis of ovarian masses in young girls is important and can be reached by careful physical examination, imaging and tumour markers. Surgery should be as much as possible for fertility preservation. The treatment of malignant tumors would involve complete staging, resection of the tumor, postoperative chemotherapy when indicated, to give the patient a chance for future childbearing.