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Ovarian lesions in children

Anusiri Inugala.

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Ovarian lesions are a rare condition in children but are extremely important since they can cause multiple complications and often need emergency management. This case series highlights the different types of ovarian lesions in children and varied management for each of the cases. All pediatric patients who presented with ovarian lesions to the Department of Pediatric Surgery at KIMS Hospital, Secunderabad between August 2018 and August 2021 were included in the study. All patients were evaluated with imaging (ultrasound or computed tomography) and blood tests. Blood tests included alpha fetoprotein and beta HCG. The patients were treated as per standard guidelines. Nine children were included in the study out of which 7 had ovarian cysts and 2 had mature teratoma of the ovary. Ovarian cyst was managed conservatively in 2 patients. 4 patients underwent oophorectomy out of which 2 patients had teratoma and the others had simple cyst torsion of the ovary. 3 patients underwent excision of the ovarian cyst.
Ovarian lesions in children may be cystic or solid. Neonatal ovarian cysts affect approximately 1:2500 pregnancies. Commonest presenting complaint of pediatric ovarian lesion is abdominal or pelvic mass. Ultrasound is accurate in distinguishing between cystic and solid lesions. Complications are usually seen in lesions over 4 – 5 cm. Ovarian tumors may be benign or malignant. Surgery is indicated when there is an enlargement of the cyst, if complications arise, and cysts of 4-5 cm persisting over 6 months. Preferred surgical management involves ovarian sparing techniques.

Key words: Ovarian cyst, Torsion of ovary, Hemorrhagic ovarian cyst, Teratoma of ovary

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