Surgery for ovarian masses in infants, children, and adolescents: 102 consecutive patients treated in a 15-year period
Surgery for ovarian masses in infants, children, and adolescents: 102 consecutive patients treated in a 15-year period
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DOI：
10.1053/jpsu.2001.22939
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发表时间：
2001-05-01
影响因子：
2.4
通讯作者：
Nuchtern, JG
中科院分区：
文献类型：
--
作者：
Cass, DL;Hawkins, E;Nuchtern, JG
背景/目的：卵巢病理虽然在儿童中很少见，但必须包括在所有有腹痛、腹部肿块或性早熟的女孩的鉴别诊断中。方法：为了提高对这些病变的临床认识，作者回顾了自1985年以来在该院接受手术治疗的所有卵巢病理患者的表现、评估和结果。结果：102名女孩(年龄9.8±5.5岁，2天至20岁)接受了106次单独的卵巢手术(43例输卵管卵巢切除术，21例卵巢切除术，33例卵巢膀胱切除术，9例卵巢活检)。在那些表现为急性腹痛的患者(n=59)中，25例(42%)有卵巢扭转(14例合并成熟畸胎瘤)，仅1例(2%)有恶性肿瘤。相反，在那些出现腹部肿块的患者(n=23)中，6例(26%)患有恶性肿瘤。良性疾病组(9.9±5.6岁；n=96)与恶性肿瘤组(8.6±3.9岁，n=10)比较，差异无统计学意义。9例疑似恶性肿瘤患儿行10例手术治疗，其中无性细胞瘤3例，卵黄囊瘤灶未成熟畸胎瘤2例，幼年颗粒细胞瘤2例，卵黄囊瘤1例，支持间质细胞瘤1例。这些患者都接受了单侧输卵管卵巢切除术，4例接受了化疗，现在都获得了8.4+/-4.1年的随访。结论：卵巢病理仍然是20岁以下女孩手术的罕见指征。由于这些病变大多是良性的，只要可行，就应该进行保留卵巢的手术。儿科外科杂志36：693-699。版权所有(C)2001，由W.B.Saunders公司提供。
Background/Purpose: Ovarian pathology, although rare in children, must be included in the differential diagnosis of all girls who present with abdominal pain, an abdominal mass, or precocious puberty.Methods: To improve clinical appreciation of these lesions, the authors reviewed the presentation, evaluation, and outcome of all patients with ovarian pathology surgically treated at their institution since 1985.Results: One hundred two girls (aged 9.8 +/- 5.5 years; range, 2 days to 20 years) underwent 106 separate ovarian operations (43 salpingo-oophorectomies, 21 oophorectomies, 33 ovarian cystectomies, and 9 ovarian biopsies). Of those presenting with acute abdominal pain (n = 59), 25 (42%) had ovarian torsion (14 associated with a mature teratoma), and only 1 (2%) had a malignant tumor. In contrast, of those presenting with an abdominal mass (n = 23), 6 (26%) had malignancies. There was no age difference between those with benign disease (9.9 +/- 5.6 years; n = 96) and those with malignant tumors (8.6 +/- 3.9 years, n = 10). Nine children had 10 operations for presumed malignant tumors (3 dysgerminomas, 2 immature teratomas with foci of yolk sac tumor, 2 juvenile granulosa cell tumors, 1 yolk sac tumor, and 1 Sertoli-Leydig cell tumor). These patients all had unilateral salpingo-oophorectomy, 4 had chemotherapy, and all are now disease free at 8.4 +/- 4.1 years follow-up.Conclusions: Ovarian pathology remains a rare indication for surgery in girls less than 20 years of age. Because most of these lesions are benign, ovarian-preserving operations should be performed whenever feasible. J Pediatr Surg 36:693-699. Copyright (C) 2001 by W.B. Saunders Company.