Advantage of conservative surgical management of large ovarian neoplasms in adolescents

Objective

To measure the postoperative size and volume of the ovary after cystectomy for a neoplasm ≥10 cm.

Design

Retrospective case series.

Setting

Academic medical center.

Patient(s)

Nine patients who underwent surgical management for an ovarian neoplasm at Children's Hospital Boston between November 2003 and November 2007.

Intervention(s)

Patients were evaluated by ultrasound postoperatively.

Main Outcome Measure(s)

Sonographic size and volume of the ovary after cystectomy for an ovarian neoplasm ≥10 cm.

Result(s)

The mean age of the patients was 14.2 ± 2.2 years, ranging between 10 and 17 years. The mean preoperative size of the ovarian neoplasm was 14.8 ± 3.8 cm, ranging between 10 and 20 cm. Serum tumor markers were negative in seven out of nine patients. There were no borderline tumors or malignancies identified. There was no statistically significant difference between the size or volume of the affected ovary and the contralateral ovary at the time of postoperative evaluation.

Conclusion(s)

Postoperative ultrasound revealed that the affected ovary resumed its normal size and volume despite the attenuated appearance of the ovarian cortex at the time of surgery. Ovarian cystectomy should be the preferred surgical approach for adolescents to ensure conservation of ovarian tissue.

Key Words: Adolescents, ovarian neoplasm, ovarian cyst, cystectomy, pelvic ultrasound, serum tumor markers