A, 13 yrs old girl BMI--27 presented in gynae opd with the chief complaint of abdominal swelling and off and on pain .Pain was dull in nature and it was unrelated to food or any physical activity,
Menstrual history; She got her menarche at 11 yrs of age but she has just 3 to 4 periods in 2 years .She got her medication started from December 2023 and an ultrasound was done which reported a parovarian cyst 78mm*69 mm on the right side .
She was put on hormonal pills for six months by some consultant.
Follow up ultrasound done after six months showed no change in the size of the cyst .The cyst appeared clear .Owing to the size of the cyst , the decision of laproscopy was taken.
On laproscopy ,there was a big parovarian cyst adjacent to right ovary .The cyst wall was enucleated and removed Both tubes appeared normal and both ovaries are polycystic .
The plan is to put the patient on diet and life style changes and progesterone withdrawl for regulation of her menstrual periods.
Management of Adolescent ovarian cyst involves understanding the underlying cause.
Understanding Ovarian Lesions and Neoplasms in Children and Adolescents
Ovarian health is a crucial aspect of overall well-being, even in young individuals. Children and adolescents can develop a range of ovarian conditions, both non-neoplastic and neoplastic. Let's delve into the types of ovarian lesions and tumors that can occur in this age group, their clinical manifestations, and the importance of specialized care.
Non-Neoplastic Ovarian Lesions
Non-neoplastic ovarian lesions are relatively common and include:
Types of Ovarian Neoplasms
Ovarian neoplasms are classified into four main categories:
Clinical Manifestations
Symptoms of ovarian masses can vary but typically include:
When evaluating ovarian masses in children and adolescents, the primary goal is to determine the likelihood of malignancy. This is crucial because the management of benign and malignant lesions is very different. Key indicators of malignancy include:
Imaging techniques like transabdominal ultrasonography, magnetic resonance imaging (MRI), and computed tomography (CT) scans are essential tools. They help visualize the mass and assess its characteristics. Additionally, certain tumor markers can raise concern for malignancy:
However, it's important to note that the serum levels of these markers alone cannot definitively confirm or exclude malignancy.
The management of pediatric ovarian masses should aim to be both curative and function-preserving. Minimally invasive techniques are preferred when feasible. Given the complexity of these cases, it's essential that children and adolescents with ovarian masses are treated in specialized centers. This approach ensures accurate diagnosis, appropriate treatment, and avoids unnecessary procedures like oophorectomies.
Ovarian lesions and neoplasms in children and adolescents require careful evaluation and specialized care. Understanding the types of lesions, their clinical presentations, and the appropriate diagnostic and management strategies is crucial for ensuring the best outcomes for young patients. By prioritizing function-preserving and minimally invasive treatments, healthcare providers can help maintain both the health and future fertility of their young patients.
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