WOFAPS 2025 8th World Congress of Pediatric Surgery

Asya Eylem Boztaş, Ayşe Demet Payza, Süleyman Perçin, Arzu Şencan

Behçet Uz Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Çocuk Cerrahisi Kliniği, İzmir/ Türkiye

Aim: This study aims to evaluate our clinical approach and surgical outcomes for pediatric ovarian pathologies in light of the current literature.

Methods: A retrospective analysis was conducted on the demographic, laboratory, sonographic, surgical, and histopathological data of 1000 patients who were followed up and treated for ovarian cysts/masses(ICD code Q50.1) in our clinic between 2018 and 2024.

Results: A total of 786 patients were included in the study, with a mean age of 12 years(0–17 years). Of these, 243 patients(31%) were in the pre-menarche period. The most frequent symptom was pelvic tenderness, followed by palpable pelvic masses. Ovarian torsion was diagnosed in 11% of the patients Excluding torsion, only 10% of patients required surgical intervention due to ovarian mass. Open surgery was performed in 52% of cases, while laparoscopic surgery was conducted in 48%.. Among operated patients 63% of masses were pure cystic, 10.7% were both solid and cystic, 2% were solid masses, 23.3% were necrotic ovarian structures. Malignancy rate was 0.4%. The most common surgical procedure was cyst excision(64.4%) for benign masses, while oophorectomy was the most frequently performed procedure for malignant masses. The rate of oophorectomy among all procedures was 21%. The most prevalent histopathologic diagnosis was simple/corpus luteum cyst, followed by mature cystic teratoma and cystadenomas for benign lesions. Yolk sac tumor and sertoli cell tumors were identified as malignant masses.

Conclusion: Ovarian masses in pediatric and adolescent patients are predominantly benign, and are followed conservatively. Given the low incidence of malignancy and the importance of preserving future fertility, minimal invasive ovarian-sparing surgery should be considered as the first approach in these patients.