From neonate to adolescent: A review of ovarian mass management in a single center

Vollständiger Abstract

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Aim: Pediatric ovarian and adnexal masses encompass a broad spectrum of benign and malignant pathologies, with management strategies ranging from observation to surgery. This study aimed to evaluate the clinical presentation, management approaches, surgical outcomes, and histopathological findings of pediatric ovarian and adnexal masses across the full age spectrum, from the neonatal period to adolescence, at a single tertiary center.Materials and Methods: A retrospective analysis was conducted on the demographic, laboratory, sonographic, surgical, and histopathological data of pediatric patients (0-18 years) who were followed up and treated for adnexal cysts/masses in our clinic between 2018 and 2024. Subgroup analyses were conducted between neonatal and non-neonatal patients.Results: A total of 786 of 1000 screened patients were included in the final analysis, with a mean age of 11.99 ± 5.28 years; 93 patients (11.8%) were in the neonatal period. Conservative management was the predominant strategy, used in 634 patients (80.7%), while 152 patients (19.3%) underwent surgery. Among operated patients, ovarian-sparing procedures were most common, with cyst excision performed in 99 patients. Oophorectomy was required in 32 patients, and salpingo-oophorectomy in 21 patients. Histopathological evaluation demonstrated predominantly benign lesions (98%), with only two malignant tumors identified. The rate of surgical intervention did not differ significantly between neonatal and non-neonatal patients (14.0% vs. 20.1%, p=0.163). However, neonatal patients had significantly higher ovarian loss rates among operated cases (p=0.007).Conclusions: Pediatric adnexal masses are predominantly benign and can be safely managed conservatively in most patients. When surgery is required, ovarian preservation should be prioritized whenever feasible. Neonatal patients represent a distinct subgroup with longer surveillance needs and higher rates of ovarian loss, supporting age-specific management strategies.