Surgically Managed Ovarian Masses at the Royal Children's Hospital, Melbourne -19 Year Experience.

Adolescent Australia / epidemiology Child Female Hospitals, Pediatric Humans Ovarian Neoplasms / diagnosis Retrospective Studies
Ovarian mass adolescent ovarian cyst ovarian neoplasm ovarian torsion pediatric surgery

Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 16 07 2018
revised: 07 04 2019
accepted: 11 05 2019
pubmed: 5 6 2019
medline: 20 12 2019
entrez: 5 6 2019
Statut: ppublish

Résumé

To describe the clinicopathological characteristics and management of surgically removed ovarian masses at the Royal Children's Hospital, Melbourne from 1993 to 2012. Medical records were reviewed retrospectively. Data regarding clinical findings, imaging and surgical management were evaluated. 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. 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. Level IV - case series with no comparison group TYPE OF STUDY: Retrospective Study.

Sections du résumé

BACKGROUND/PURPOSE OBJECTIVE
To describe the clinicopathological characteristics and management of surgically removed ovarian masses at the Royal Children's Hospital, Melbourne from 1993 to 2012.
METHODS METHODS
Medical records were reviewed retrospectively. Data regarding clinical findings, imaging and surgical management were evaluated.
RESULTS 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 CONCLUSIONS
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.
LEVEL OF EVIDENCE METHODS
Level IV - case series with no comparison group TYPE OF STUDY: Retrospective Study.

Identifiants

DOI: 10.1016/j.jpedsurg.2019.05.005 PMID: 31160084
pubmed: 31160084
pii: S0022-3468(19)30353-7
doi: 10.1016/j.jpedsurg.2019.05.005
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1913-1920

Informations de copyright

Crown Copyright © 2019. Published by Elsevier Inc. All rights reserved.

Auteurs

J A How (JA)

Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, Australia. Electronic address: jeuann@gmail.com.

J L Marino (JL)

Department of Obstetrics and Gynecology, Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria, Australia.

S R Grover (SR)

Department of Pediatric & Adolescent Gynecology, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia.

Y Heloury (Y)

Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia; Department of Pediatric Surgery, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, Australia.

M Sullivan (M)

Children's Cancer Centre, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, Australia.

A Mellor (A)

Mater Adolescent and Young Adult Health Centre, Raymond Terrace, South Brisbane, Queensland, Australia.

O McNally (O)

Department of Gynecological Oncology, Royal Women's Hospital, Melbourne, 20 Flemington Road, Parkville, Victoria, Australia.

Y Jayasinghe (Y)

Department of Obstetrics and Gynecology, Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria, Australia; Department of Pediatric & Adolescent Gynecology, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, Victoria, Australia.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Surgically Managed Ovarian Masses at the Royal...
questionsmedicales.fr › Régions géographiques › Océanie › Australasie › Australie › Surgically Managed Ovarian Masses at the Royal...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Surgically Managed Ovarian Masses at the Royal...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Hôpitaux › Hôpitaux spécialisés › Hôpitaux pédiatriques › Surgically Managed Ovarian Masses at the Royal...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Surgically Managed Ovarian Masses at the Royal...
questionsmedicales.fr › Maladies endocriniennes › Troubles gonadiques › Maladies ovariennes › Tumeurs de l'ovaire › Surgically Managed Ovarian Masses at the Royal...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Surgically Managed Ovarian Masses at the Royal...