Mashaba Nkhensani C, Mbodi Langanani, Mapunda Ellen M, Omar Tanvier, Harrison Derek S
Department of Pediatric Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Pediatric Surgery, Polokwane-Mankweng Tertiary and Academic Hospital, University of Limpopo, Polokwane, South Africa.
Cancer Rep (Hoboken). 2025 Nov;8(11):e70396. doi: 10.1002/cnr2.70396.
Existing literature on ovarian masses necessitating intervention in children by pediatric surgeons and gynecologists in Low- and Middle-Income Countries is sparse and lacks collaborative standardization in management between the two subspecialties. Therefore, this study seeks to assess the range of ovarian masses presenting to these two specialties and to explore variations in management.
A 15-year retrospective review of surgically biopsied or excised ovarian masses between subspecialties at two academic hospitals in Johannesburg.
We identified 288 patients, six with bilateral disease and 294 ovarian masses. The mean age was 13.34 years (SD ±5.12). The most common presentation was abdominal pain in 149/288 (51.74%); 117 patients (40.62%) were from pediatric surgery and 171 (59.38%) from gynecology departments. There were 127/288 (44.09%) non-neoplastic and 161/288 (55.90%) neoplastic lesions, of which 110/161 (68.33%) were benign and 51/161 (31.67%) malignant. The neoplastic lesions consisted of 107/161 (66.45%) germ cells, 28/161 (17.39%) surface epithelial tumors, and 26/161 (16.14%) sex cord-stromal tumors. Ovarian-sparing surgery was done in 56/288 (19.44%) patients, 22/117 (18.80%) in pediatric surgery, and 34/171 (19.88%) in gynecology. Laparoscopy was done in 57/288 (19.79%) patients, 24/117 (20.51%) in pediatric surgery, and 19/171 (19.29%) in gynecology. The survival rate in benign masses was 100%, and 86.28% in malignancies.
This study highlights the diverse spectrum of ovarian masses managed by pediatric surgeons and gynecologists. A laparoscopic approach combined with ovarian preservation, which was comparable between specialties, should be the preferred method for managing benign lesions whenever feasible. These findings underscore the need for standardized, collaborative guidelines between pediatric surgeons and gynecologists to ensure consistent and optimal management of ovarian masses in children.
关于低收入和中等收入国家儿科外科医生和妇科医生对需要干预的儿童卵巢肿块的现有文献稀少，且这两个亚专业之间在管理上缺乏协作标准化。因此，本研究旨在评估这两个专业所处理的卵巢肿块范围，并探讨管理上的差异。
对约翰内斯堡两家学术医院两个亚专业之间手术活检或切除的卵巢肿块进行了为期15年的回顾性研究。
我们确定了288例患者，其中6例为双侧病变，共294个卵巢肿块。平均年龄为13.34岁（标准差±5.12）。最常见的表现是腹痛，149/288例（51.74%）；117例患者（40.62%）来自儿科外科，171例（59.38%）来自妇科。有127/288例（44.09%）为非肿瘤性病变，161/288例（55.90%）为肿瘤性病变，其中110/161例（68.33%）为良性，51/161例（31.67%）为恶性。肿瘤性病变包括107/161例（66.45%）生殖细胞肿瘤、28/161例（17.39%）表面上皮肿瘤和26/161例（16.14%）性索间质肿瘤。56/288例（19.44%）患者进行了保留卵巢手术，儿科外科为22/117例（18.80%），妇科为34/171例（19.88%）。57/288例（19.79%）患者进行了腹腔镜检查，儿科外科为24/117例（20.51%），妇科为19/171例（19.29%）。良性肿块的生存率为100%，恶性肿块的生存率为86.28%。
本研究强调了儿科外科医生和妇科医生所处理的卵巢肿块的多样性。腹腔镜手术联合卵巢保留，两个专业之间情况相当，只要可行，应是处理良性病变的首选方法。这些发现强调了儿科外科医生和妇科医生之间需要标准化的协作指南，以确保对儿童卵巢肿块进行一致且最佳的管理。
