Introducere: Tumorile ovariene la pacienţii pediatrici se intalnesc rar, mai mult, tumorile maligne sunt
şi mai rar intâlnite. Scopul studiului a fost evaluarea abordării chirurgicale în managementul tumorilor ovariene
la copii şi adolescenţi.
Materiale şi metode: Pe parcursul a 14 ani am efectuat un studiu prospectiv a tumorilor ovariene
întalnite la copii.
Rezultate: Studiul a inclus 183 paciente cu vârsta medie 15.6±0.2 (8-18 ani). Acuzele principale au
fost : durerea abdominala – 169 paciente (92.3%), urmată de dereglări ale ciclului menstrual – 42 paciente (22.9%) şi masa abdominala palpabila – 21 paciente (11,5%). Torsiunea de anexa a fost diagnosticată la 23
(12.5%) paciente. Diagnosticul a fost bazat pe rezultatele USG, CT sau RMN. Media dimensiunilor
formaţiunilor a fost de 9.5±0.4 cm. Rata formaţiunilor ovariene unilaterale a fost semnificativ mai înaltă în
comparaţie cu cele bilaterale (90.7% vs. 9.3%, p<0.001). În 123 (67,2%) cazuri a fost realizată laparotomia,
iar în 59 (32.8%) cazuri laparoscopia (conversie in 1 caz – 1,7%). Procedura chirurgicală de bază a fost operaţiile
organo-menajante (n=161, 80.9%, p<0.001). In celelalte 19,1% cazuri s-au efectuat – salpingo-ovarectomia
(n=29), ovarectomia (n=8), si histerectomia subtotala cu anexectomie bilaterală (n=1). Rezultatele histologice
au relevant: Chist simplu (n=120), chist dermoid (n=35), chistadenom (n=33), endometriom (n=4), chist hidatic
(n=2), fibrom (n=2) si tumoră cu celule granuloase / tecom (n=3).
Concluzie : Tratamentul chirurgical de preferinţă la populaţia pediatrică ar trebui să presupună
prezervarea ţesutului ovarian în scopul conservării funcţiei fertile pe viitor.

Introduction: Ovarian masses in the pediatric age group are rare, and malignancies are even less
common. The aim of study was to evaluate the surgical approach used in the management of ovarian mass in the
pediatric and adolescent population.
Materials & Methods: We prospectively reviewed the cases of ovarian masses in children in our
institution over a fourteen years period.
Results: A total of 183 pts with mean age 15.6±0.2 (range 8-18) years were included in study. The main
complaint was abdominal pain in 169 patients (92.3%), followed by menstrual disorder in 42 (22.9%) cases and
abdominal swelling in 21 (11.5%) cases. Adnexal torsion was diagnosed in 23 (12.5%) pts. The diagnosis based
on USG, CT or MRI, and the mean mass size was 9.5±0.4 cm. A significantly higher rate of unilateral mass was
found compared with bilateral lesions (90.7% vs. 9.3%, p<0.001). In 123 (67.2%) surgical procedures were
performed via laparotomy and 59 (32.8%) via laparoscopy (conversion rate 1.7%). The ovarian-preserving
surgery was the predominantly performed procedure (n=161, 80.9%, p<0.001). In other 19.1% of cases were
performed: salpingo-oophorectomy (n=29), oophorectomy (n=8) and subtotal hysterectomy with bilateral
adnexectomy (n=1). The histopathological report revealed: simple cyst (n=120), dermoid cyst (n=35), cystadenoma
(n=33), endometrioma (n=4), hydatid cyst (n=2), fibroma (n=2), and granulose/theca cell tumor (n=3).
Conclusion: Sparing surgery should be the preferred surgical approach for pediatric and adolescent
population in order to ensure conservation of ovarian tissue for the future fertility.