Khedkar Kiran, Shah Hemanshi, Tiwari Charu, Makhija Deepa, Waghmare Mukta
Dept of Paediatric Surgery, TNMC & BYL Nair Hospital, Mumbai Central, Mumbai, 400008, Maharashtra, India.
Int J Pediatr Adolesc Med. 2016 Dec;3(4):169-174. doi: 10.1016/j.ijpam.2016.08.010. Epub 2016 Oct 5.
Adnexal masses are rare in the pediatric age group. We present our experience with 20 patients with adnexal masses.
This retrospective observational analysis was performed on 20 children with adnexal masses who were treated at our institute between May 2011 and November 2015.
Fifteen pediatric patients who were admitted between May 2011 and November 2015 were reviewed and retrospectively analyzed based on their age at the time of admission, their presenting complaints, clinical and radiological findings, tumor markers, management and follow-up.
The patients' age at the time of admission ranged between 3 days and 12 years. Abdominal pain and lump were the most common presenting complaints.Four patients (20%) had antenatally diagnosed cystic ovarian lesions. On postnatal scan, two patients had a simple cyst measuring less than 6 cm, which resolved on follow-up ultrasound at 3 months. One neonate had a simple cyst, larger than 6 cm on postnatal scan, which was managed by marsupialization. One antenatally diagnosed patient had a dermoid cyst that required oophorectomy.Ten patients (50%) had dermoid cyst and underwent complete surgical excision of the mass. Based on histopathologic results, two of these patients had immature teratoma and required adjuvant chemotherapy (Bleomycin, Etoposide, and Cisplatin). The serum AFP levels of these patients were carefully monitored.One patient with bilateral ovarian cysts was diagnosed with Van Wyk-Grumbach syndrome, which resolved significantly after a 3-month regimen of thyroxin supplementation.Five patients presented with torsion and required emergency surgery-three had mature teratoma, one had an immature teratoma and one had large simple cysts.
The majority of ovarian tumors are benign. Accurate staging, complete resection and chemotherapy for the treatment of malignant tumors have contributed to excellent survival rates in these patients.
附件肿物在儿童年龄组中较为罕见。我们介绍20例附件肿物患者的诊疗经验。
对2011年5月至2015年11月在我院接受治疗的20例患有附件肿物的儿童进行了这项回顾性观察分析。
对2011年5月至2015年11月入院的15例儿科患者进行回顾，并根据其入院时的年龄、主诉、临床及影像学检查结果、肿瘤标志物、治疗及随访情况进行回顾性分析。
患者入院时年龄在3天至12岁之间。腹痛和肿块是最常见的主诉。4例患者（20%）产前诊断为卵巢囊性病变。出生后扫描显示，2例患者有直径小于6cm的单纯囊肿，在3个月后的超声随访中囊肿消失。1例新生儿出生后扫描显示有直径大于6cm的单纯囊肿，采用袋形缝术治疗。1例产前诊断的患者有皮样囊肿，需行卵巢切除术。10例患者（50%）有皮样囊肿，均接受了肿物的完整手术切除。根据组织病理学结果，其中2例患者为未成熟畸胎瘤，需接受辅助化疗（博来霉素、依托泊苷和顺铂）。对这些患者的血清甲胎蛋白水平进行了密切监测。1例双侧卵巢囊肿患者被诊断为范怀克-格伦巴赫综合征，补充甲状腺素3个月后症状明显缓解。5例患者出现扭转，需急诊手术——3例为成熟畸胎瘤，1例为未成熟畸胎瘤，1例为巨大单纯囊肿。
大多数卵巢肿瘤为良性。准确分期、完整切除以及对恶性肿瘤进行化疗，使这些患者的生存率很高。
