To investigate the incidence, clinical features, tumor markers, radiologic findings, types of surgeries, and histologies for adnexal masses in pediatric and adolescent females.
Retrospective chart review.
Children’s Health in Dallas/Plano from 2009-2018.
Female patients <19 years old who underwent surgical management of an adnexal mass.
Imaging characteristics, tumor markers, surgical procedures, and histopathology.
In total, 752 patients (mean age 13.7 years) underwent 756 surgical procedures for 781 adnexal masses. Of these, 732 were benign (93.7%), 7 were borderline (0.9%), and 42 were malignant (5.4%). Of all 781 masses, 520 (66.6%) were ovarian and 261 (33.4%) were paratubal or tubal. Benign masses were associated with Hispanic race, pain, simple/cystic characteristics on imaging, and negative tumor markers. Borderline and malignant masses were associated with white race, pain, mass/distension, larger size, and heterogeneous appearance on imaging. Borderline masses were associated with negative tumor markers. Malignant masses were associated with elevated alpha fetoprotein (aFP), beta human chorionic gonadotropin (ß-hCG), CA-125, and lactate dehydrogenase (LDH).
The majority of adnexal masses in the pediatric and adolescent population are benign. Benign masses were significantly smaller, more likely to have negative tumor markers, and appear simple/cystic. There is little standardization with respect to preoperative tumor markers for adnexal masses. High yield tumor markers for malignancy include AFP, b-hCG, CA-125, and LDH. Low yield tumor markers include Inhibin A and B. Gynecologists performed more fertility-preserving surgeries including mini-laparotomies and fewer laparotomies for benign masses than pediatric surgeons.

Copyright © 2021. Published by Elsevier Inc.