Evaluation and Treatment Results of Ovarian Cysts in Childhood and Adolescence: A Multicenter, Retrospective Study of 100 Patients

• Published in: Journal of pediatric & adolescent gynecology Vol. 30; no. 4; pp. 449 - 455
• Main Authors: Aydin, Banu Kucukemre, MD, Saka, Nurcin, MD, Bas, Firdevs, MD, Yilmaz, Yasin, MD, Haliloglu, Belma, MD, Guran, Tulay, MD, Turan, Serap, MD, Bereket, Abdullah, MD, Yesiltepe Mutlu, Gul, MD, Cizmecioglu, Filiz, MD, Hatun, Sukru, MD, Bezen, Digdem, MD, Tutunculer, Filiz, MD, Cebeci, Nurcan, MD, Isguven, Pinar, MD, Memioglu, Nihal, MD, Ercan, Oya, MD, Poyrazoglu, Sukran, MD, Bundak, Rüveyde, MD, Darendeliler, Feyza, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2017
• Subjects: Adolescent; Aromatase inhibitors; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Obstetrics and Gynecology; Ovarian cyst; Ovarian Cysts - complications; Ovarian Cysts - diagnosis; Ovarian Cysts - therapy; Ovarian Neoplasms - complications; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - therapy; Ovarian torsion; Ovarian tumor; Pediatrics; Precocious puberty; Puberty, Precocious - etiology; Puberty, Precocious - therapy; Retrospective Studies; Treatment Outcome; Turkey; Turkey; Ovarian cyst; Ovarian torsion; Ovarian tumor; Precocious puberty; Aromatase inhibitors
• ISSN: 1083-3188; 1873-4332
• DOI: 10.1016/j.jpag.2017.01.011

Abstract Study Objective To investigate the characteristics of children with ovarian cysts and evaluate treatment strategies. Design Retrospective study. Setting Eight pediatric endocrinology clinics, Turkey. Participants A total of 100 children and adolescents with ovarian cysts. Interventions Patient data collected via retrospective chart review. Patients were stratified according to age into 4 groups (newborns, 1-12 months, 1-8 years, and 8-18 years). Main Outcome Measures Special emphasis was given to torsion and tumor cases, concomitant diseases, treatment modalities, and problems during follow-up. Results Most newborns and infants were asymptomatic with the cysts being discovered incidentally; in girls ages 1-8, symptoms were common, including breast budding (47.1%, 16 of 34) and vaginal bleeding (29.4%, 10 of 34). Girls older than 8 years mostly presented with abdominal pain (31.6%, 12 of 38) and menstrual irregularity (21.1%, 8 of 38). Most of our patients were diagnosed with a simple ovarian cyst, but 9 patients were found to have ovarian tumors. Ovarian torsion was detected in 7 patients; 5 with large and 2 with small cysts (<20 mm). Two patients had central precocious puberty (CPP) at presentation and 5 patients developed CPP during follow-up. The surgical intervention rate was high (38%, 38 of 100), but was associated with earlier treatment year, and this association remained significant after adjusting for confounders ( P  = .035). Conclusion Most girls have simple cysts, which have a favorable prognosis without intervention; however, there might be coexisting pathologies or complications such as tumors, torsion, and CPP; hence these patients should be evaluated accordingly and treated with a multidisciplinary approach.