ABSTRACT
Ovarian masses are uncommon in children. These lesions, whether cystic, solid or mixed, span a spectrum of pathology from functional (non-neoplastic) ovarian cysts to ovarian torsion, and from benign lesions to highly aggressive malignant neoplasms. About 45 percent of ovarian masses are functional benign cysts such as follicle cysts and corpus luteum cysts. Another 40 percent are benign neoplasms, most commonly benign cystic teratomata (dermoid cysts). The remaining 15 percent are malignant neoplasms. (See Table 64.1)
Ovarian masses may occur at any age, in infants as well as in adolescents. They may be unilateral or bilateral, cystic unilocular or multilocular, or solid. They come to surgical attention in a variety of ways. Some are detected incidentally during ultrasound examination prenatally or postnatally, whereas others present insidiously as painless abdominal swellings. Most patients suffer from (acute or chronic) abdominal pain. Acute symptoms may be caused by torsion, bleeding or rupture of large cysts. Constipation, nausea and vomiting, as well as fatigue, are also reported. More rarely, there may be symptoms of precocious puberty or of virilization, and a pelvic mass is often palpated.
