The distribution of histology, staging and surgical approach to pediatric ovarian tumors differs significantly from that in adults.
Ovarian tumors are uncommon in children. Differentiating benign from malignant masses in this heterogeneous group of tumors can be challenging. Yet for both the surgeon and the patient, making the distinction is critical in providing appropriate surgical treatment, assuring accurate staging and preserving fertility in a group of patients whose lesions are largely expected to be benign. Given the rarity of ovarian tumors and the role that most pediatric surgeons play as the primary provider responsible for managing abdominal masses in children, it is incumbent upon pediatric surgeons to understand the pathology and appropriate treatment algorithms when encountering an ovarian mass.
What are the most critical issues in taking care of patients with ovarian tumors?
The optimal care of pediatric patients with ovarian tumors requires early recognition of the diagnosis and a thorough knowledge of the treatment priorities based on the likely histology and risk of malignancy. Complete staging based on tumor type and an overall bias to preserve fertility should guide the surgical care.
Which aspects of managing ovarian tumors are the most challenging for the pediatric surgeon?
The most challenging part of managing ovarian tumors for pediatric surgeons is having a high index of suspicion when working up an abdominal mass in a female and knowing the radiologic, laboratory and surgical principles required to appropriately manage the mass without compromising the oncologic principles mandated to drive optimal outcomes. Failure to appropriately stage the patient or errors in surgical management can adversely impact outcomes while overly aggressive surgery can result in unnecessary loss of reproductive function.
Content in these topics is referenced in SCORE Ovarian and Adnexal Problems overview
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