Clinico Pathological Review of Adnexal Masses in Children and Adolescents at a University Hospital

Background & Objective:The study objective was to review the clinic-pathological characteristics of adnexal masses in the children and adolescent population in our institution.Methods:Retrospective analysis of 178 adolescent patients including neonates, presenting with adnexal masses between January 2000-December 2012, was performed. Results: Records of a total of 178 patients were analyzed. The mean age was 14 years. The most common symptom was abdominal pain noted in 146(82%) patients followed by nausea and vomiting in 28(15.7%) and incidental findings in 19(10.7%). The majority of the ovarian masses were benign. The follicular cyst was the most common histopathological type in 66 patients (37.1%) followed by a hemorrhagic cyst in 40(22.5%), benign teratoma in 21(11.8%), benign serous cyst in 20 patients (11.2%), endometrioma and mucinous cystadenoma in 13 patients (7.3%). The average tumor size observed in the present study was 7.84cms. However, the size varied in different age groups such as 4.27 cm size in neonates, and 7.1 cm in 1-14 years age group, and 8.61 cm in 15-19 years age group with a P-value of 0.009. Out of a total of 178 patients, 46(25.8%) were managed conservatively. However, 90(50.6%) patients underwent ovarian cystectomy, 26(14.6%) were managed by unilateral salpingo-oophorectomy, 10(5.6%) by unilateral oophorectomy. Aspiration and biopsy were done in 6(3.4%) patients.Conclusion:Incidence of adnexal masses increases with age with maximum cases between age 14 and above. Adolescent girls with adnexal masses can have variable presentations however abdominal pain is the most common symptom. Mostly these are benign masses therefore conservative approach for treatment should be adopted.