A fifteen-year retrospective review of surgically managed ovarian masses in children at Charlotte Maxeke Johannesburg and Chris Hani Baragwanath Academic Hospitals

Abstract

Background and objectives Existing literature on ovarian masses necessitating intervention in children by pediatric surgeons and gynecologists in Low- and Middle-Income Countries is sparse. Therefore, this study seeks to assess the range of ovarian masses presenting to these two specialties and to explore variations in management. Methods A retrospective review of surgically biopsied or excised ovarian masses at two academic hospitals in Johannesburg. Results We identified 288 patients, six with bilateral disease hence 294 ovarian masses. Mean age of 13.3 years (SD ± 5.1). The most common presentation was abdominal pain 149/288 (52%); 117 patients (41%) were from pediatric surgery and 171 (59.4%) from gynecology departments. There were 127/288 (44.1%) non-neoplastic and 161/288 (56%) neoplastic lesions, of which 110/161 (68.3%) were benign and 51/161 (32%) malignant. The neoplastic lesions consisted of 107/161 (67%) Germ cells, 28/161 (17.4%) Surface epithelial-stromal and 26/161 (16.1%) Sex cord-stromal tumors. Ovarian-sparing surgery was done in 56/288 (19.4%) patients, 22/117 (19 %) in pediatric surgery, and 34/171 (20%) in gynecology. Laparoscopy was done in 57/288 (20%) patients, 24/117 (21%) in pediatric surgery,and 19/171 (19.3%) in gynecology. Malignancy survival was 86.3%. Conclusion The findings underscore the importance of considering ovarian lesions in girls with abdominal pain. With most masses being benign, preserving fertility, preferably via minimally invasive surgery, is crucial.