Abstract
Study Objective
To investigate the incidence, clinical features, tumor markers, radiologic findings,
types of surgeries, and histologies for adnexal masses in female pediatric and adolescent
patients.
Design
Retrospective chart review.
Setting
Children's Health in Dallas and Plano, Texas from 2009 to 2018.
Participants
Female patients younger than 19 years old who underwent surgical management of an
adnexal mass.
Interventions
None.
Main Outcome Measures
Imaging characteristics, tumor markers, surgical procedures, and histopathology.
Results
In total, 752 patients (mean age, 13.7 years) underwent 756 surgical procedures for
781 adnexal masses. Of these, 732/781 (93.7%) were benign, 7/781 (0.9%) were borderline,
and 42/781 (5.4%) were malignant. Of all 781 masses, 520/781 (66.6%) were ovarian
and 261/781 (33.4%) were paratubal or tubal. Benign masses were associated with Hispanic
race, pain, simple or cystic characteristics on imaging, and negative tumor markers.
Borderline and malignant masses were associated with white race, pain, mass or distension,
larger size, and heterogeneous appearance on imaging. Borderline masses were associated
with negative tumor markers. Malignant masses were associated with elevated alpha
fetoprotein, beta human chorionic gonadotropin, cancer antigen 125, and lactate dehydrogenase.
Conclusion
Most adnexal masses in the pediatric and adolescent population are benign. Benign
masses were significantly smaller, more likely to have negative tumor markers, and
appear simple or cystic. There is little standardization with respect to preoperative
tumor markers for adnexal masses. High-yield tumor markers for malignancy include
alpha fetoprotein, beta human chorionic gonadotropin, cancer antigen 125, and lactate
dehydrogenase. Low-yield tumor markers include inhibin A and B. Gynecologists performed
more fertility-preserving surgeries including mini-laparotomies and fewer laparotomies
for benign masses than pediatric surgeons.
Key Words
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Article info
Publication history
Published online: January 13, 2021
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.
