[Presumed benign ovarian tumors of childhood and adolescent]

Abstract

Ovarian tumors in childhood are rare, often organic with 10% of malignant cases. Functional pathology dominates in adolescence and its management is the same as the adult. The clinical symptoms of PBOT (presumed benign ovarian tumor) are non-specific. The main clinical signs are acute pain, associated with peritoneal irritation syndrome, which can suggest an ovarian torsion, a mass or the development of secondary sexual characters. Hyperestrogenemia suggests a McCune-Albright syndrome or a granulosa tumor. Hyperandrogenism evokes a malignant tumor. Pelvic ultrasound is the main examination. Pure liquid cysts are benign but could be organic if persisting beyond 6 months. MRI and tumor markers are needed for heterogeneous cyst diagnosis. The protected extraction of a cyst is recommended during the laparoscopic cystectomy. If case of doubt of malignancy, laparoscopy allows the peritoneal cavity exploration. In case of torsion, ovarian untwisting must be performed. After untwisting, the ovary must be preserved because macroscopic aspect is not predictive of the ovarian function recovery. No medical treatment is effective. After resection, US follow up is required for five years.

Keywords: Acute pain; Cystectomy; Douleur aiguë; Granulosa tumor; Kystectomie; McCune-Albright; Ovarian torsion; Pelvic US; Secreting tumor; Torsion ovarienne; Tumeur de la granulosa; Tumeur secrétante; Échographie pelvienne.