ABSTRACT
Ovarian cysts are relatively common and should be regarded as a separate entity from cystic ovarian neoplasms when considering surgical management. Neonatal ovarian cysts arise from maternal estrogen or human gonadotropin. Ovarian torsion may occur with a normal ovary, ovarian cyst, or ovarian tumor. Although elevated tumor markers are associated with malignancy, they may be normal in up to 45% of malignant pediatric ovarian masses. At present, there is insufficient evidence to support routine laparoscopic management of ovarian tumors with features to suggest malignancy. However, the available data, primarily from the adult literature, suggest the incidence of tumor rupture is unacceptably higher in the laparoscopy group versus the laparotomy group, for both oophorectomy and for enucleation. For tumors undergoing laparoscopic resection, it is imperative that the tumor be resected intact, and a retrieval technique be utilized that avoids intraperitoneal spillage.
