ABSTRACT
This chapter reviews ovarian pathology as it presents in the neonate, child, and adolescent. Adnexal masses are reported less frequently in childhood than in the adolescent owing to the low levels of gonadotropins. The differential diagnosis of the adnexal mass in childhood includes functional ovarian cysts, benign and malignant ovarian neoplasms, paratubal or paraovarian cysts, and Mullerian anomalies, as well as nongynecologic pathology. The etiology of a fetal or neonatal ovarian cyst is almost universally a functional cyst. Paratubal cysts, which are remnants of paramesonephric or mesonephric ducts, have an incidence of 7%–11% in children and adolescents undergoing surgery for adnexal pathology. In the adolescent with an adnexal mass, it is important to illicit a full menstrual and sexual history in addition to the history of the presenting symptoms. Adnexal torsion involves partial or complete twisting of the ovary and/or fallopian tube around its vascular pedicle, leading to edema, ischemia, and necrosis.
