Introducere: Tumorile ovariene (TO) la copii şi adolescente sunt o patologie destul de rară. Principiile stratificării preoperatorii a TO la pacientele pediatrice şi stabilirea volumului intervenţiei chirurgicale sunt controversate. Scop: Studierea structurii, diagnosticului şi tratamentului chirurgical al TO la copii şi adolescente. Material şi metode: A fost efectuată analiza bazei de date (n = 127) a pacientelor pediatrice cu TO, operate în perioada 2000 până 2018. Pentru diagnosticul şi stratificarea TO au fost utilzate USG, TC sau IRM. Selectiv au fost determinaţi markerii oncologici (CA 125, CEA, CA 19.9, αFP și β-hCG). Rezultate: Vârsta medie a pacientelor a constituit – 16.1±0.2 ani (95% CI:15.63 – 16.42), inclusiv premenarha (n = 5, 3.9%) şi în 2 (1.7%) cazuri – sindromul Mayer-Rokitansty-Küster-Hauser. Conform datelor radiologice, formaţiunile tumorale se caracterizau: TO mari (> 8cm) – 61 (45.9%) şi TO gigante (> 15cm) – 14 (10.5%). TO unilaterale s-au înregistrat mult mai des decât cele bilaterale (95.7% vs 4.7%). Intervenţiile chirurgicale au fost efectuate prin abord laparotomic – 95 (74.8%) și laparoscopic – 32 (25.2%) cazuri. După volumul operaţiilor au fost efectuate: tumorectomie cu păstrarea ţesutului ovarian – 101 (75.9%) cazuri, anexectomii – 23 (17.3%) şi ovarectomii – 9 (6.8%) cazuri. La examenul morfopatologic s-a stabilit ca tumorile benigne au fost depistate mult mai des decât cele maligne şi au constituit respectiv – 130 (97.7%) vs 3 (2.3%). Printre grupul tumorilor benigne predominau cele epiteliale (n = 72, 54.1%) şi germinogene (n = 53, 39.8%). Concluzii: La pacientele pediatrice se observă preponderent TO benigne. În mai mult de jumătate din cazuri TO sunt de dimensiuni mari şi gigante. În 2/3 din cazuri este posibil de efectuat tumorectomie cu păstrarea ţesutului ovarian restant.

Introduction: Ovarian tumors (OT) in children and adolescents are a rather rare pathology. The principles of preoperative stratification of OT in pediatric patients and the determination of the volume of surgery are controversial. Aim: study of the structure, diagnosis and surgical treatment of OT in children and adolescents. Material and methods: Database analysis (n = 127) of OT in pediatric patients operated between 2000 and 2018 was performed. Ecography, CT or MRI was used for the diagnosis and stratification of OT. Selectively, tumor markers (CA125, CEA, CA19.9, αFP and β-hCG) were determined. Results: Mean age of the patients – 16.1±0.2 years (95% CI: 15.63-16.42), including premenarha (n = 5, 3.9%) and 2 (1.7%) with Mayer-Rokitansty-Küster-Hauser Syndrome. According to radiologic data, tumors were characterized: large OT (> 8cm) – 61 (45.9%) and giant OT (> 15cm) – 14 (10.5%). Unilateral OT were recorded more often than bilateral (95.7% vs. 4.7%). Surgical approach by laparotomy – 95 (74.8%) and by laparoscopy – 32 (25.2%) cases. According to the volume of operations, tumorectomy with ovarian tissue preservation – 101 (75.9%) cases, anexectomies – 23 (17.3%) and ovariectomies – 9 (6.8%) cases. At pathological examination was established that benign tumors were more frequent than malignant – 130 (97.7%) vs 3 (2.3%). Among benign tumors predominated with epithelial origin (n = 72, 54.1%) and germinogenic tumors (n = 53, 39.8%). Conclusions: Ovarian tumors in pediatric patients are predominantly benign. In more than half of OT cases they are large and giant. In 2/3 of the cases it is possible to perform tumorectomy with preservation of the remaining ovarian tissue.