Clinicopathological characteristics of ovarian tumours according to menarchal status in Korean girls

Aim:  To evaluate our experience with ovarian tumours in young girls and to identify specific characteristics in relation to their menarchal status that might assist in the early diagnosis and prompt management. Methods:  Girls younger than 18 years of age who had an adnexal tumour confirmed at surgery from 1985 to 2008 were identified from the pathology database of Hanyang University Medical Centre. Clinicopathological characteristics such as patient's age, age at menarche, presenting symptoms, operative findings and final histological diagnosis were analysed. Results:  Twenty‐four of the 90 patients operated on for an ovarian tumour were pre‐menarchal and 66 were post‐menarchal. Most tumours were of germ cell origin: 83% of tumours in pre‐menarchal and 53% in post‐menarchal girls. Most of the patients complained of abdominal pain (∼70%), although a palpable mass was identified in only 17% of pre‐menarchal and 30% of post‐menarchal patients. Vomiting was a major complaint in pre‐menarchal patients (30%) but was uncommon in post‐menarchal patients (<5%). The frequency of torsion was significantly higher in pre‐menarchal (50%) than in post‐menarchal (17%) patients, and more than 90% of the torsion in pre‐menarchal patients occurred in tumours of germ cell origin. Conclusions:  The incidence of ovarian tumour and torsion is rare, especially in pre‐menarchal girls. However, we found a higher prevalence of torsion in pre‐menarchal girls with an ovarian tumour. A high level of suspicion for torsion should be considered when treating pre‐menarchal girls with an ovarian tumour, irrespective of the tumour size to preserve adnexal tissue.