van Winter J T, Simmons P S, Podratz K C
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905.
Am J Obstet Gynecol. 1994 Jun;170(6):1780-6; discussion 1786-9. doi: 10.1016/s0002-9378(12)91848-7.
We retrospectively evaluated the clinical presentation and histopathologic findings of benign and malignant adnexal masses in infants, children, and adolescents.
Between 1955 and 1992, 486 patients (aged 7 days through 20 years) with adnexal masses were surgically evaluated.
Of 521 adnexal masses, 92% were benign, including 335 nonneoplastic and 144 of 186 (77%) neoplastic lesions. The frequency of ovarian malignancies correlated inversely with patient age. Germ cell, stromal, and epithelial malignancies accounted for 40%, 21%, and 33%, respectively, of the 42 cancers. Nonconcordance between preoperative and postoperative diagnoses was noted in 94 cases. The most common preoperative diagnosis necessitating reassignment was acute appendicitis. During the last decade of this study, ultrasonography and computed tomography missed no malignancies.
Physicians who care for young girls must be familiar with the differential diagnosis of adnexal masses to advise conservative management when appropriate and surgical intervention when necessary.
我们回顾性评估了婴儿、儿童及青少年良性和恶性附件肿块的临床表现及组织病理学特征。
1955年至1992年间，对486例（年龄7天至20岁）附件肿块患者进行了手术评估。
在521个附件肿块中，92%为良性，包括335个非肿瘤性病变以及186个肿瘤性病变中的144个（77%）。卵巢恶性肿瘤的发生率与患者年龄呈负相关。在42例癌症中，生殖细胞、间质及上皮性恶性肿瘤分别占40%、21%和33%。94例患者术前与术后诊断不一致。术前最常见的需要重新诊断的疾病是急性阑尾炎。在本研究的最后十年中，超声检查和计算机断层扫描未漏诊任何恶性肿瘤。
诊治年轻女孩的医生必须熟悉附件肿块的鉴别诊断，以便在适当的时候建议采取保守治疗，在必要时建议进行手术干预。
