Introduction:Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of
all abdominal tumors in children. Abdominal pain is the most frequent initial
sign. Sometimes the discovery is fortuitous, revealed by an abdominal
ultrasound. We report here the case of an ovarian cyst in an infant in order to clarify the diagnostic and therapeutic
particularities. Patient and observation: 2-year-old
infant, female, weighing 12 kg and with no particular pathological history, was
admitted to our department for pain plus abdominal mass evolving for 2 months.The
clinical examination had noted: a mass ranging from FID to hypogastrium,
painless, of firm consistency, with regular contour, with a
smooth and mobile surface in relation to the deep plane. The abdominal ultrasound performed had concluded to a
mesenteric cyst. The treatment consisted of a monobloc total cystectomy with
preservation of the healthy ovarian tissue by a transverse laparotomy
under the umbilical. The postoperative course was simple; the histological
study of the surgical specimen had concluded to a serous cystadenoma. Conclusion: Ovarian cysts are benign tumors in most cases. Abdominal pain is the most common initial symptom at
any age. Sometimes they can be incidentally discovered by ultrasound. The
preservation of healthy ovarian tissue in the rules of oncological surgery
allows the preservation of subsequent fertility.
References
[1]
Pienkowski, C. and Kalfa, N. (2013) Presumed Benign Ovarian Tumors of Childhood and Adolescent. Journal de Gynecologie, Obstetrique et Biologie de la Reproduction, 42, 833-841.
[2]
Aydin, B.K., Saka, N., Bas, F., et al. (2017) Evaluation and Treatment Results of Ovarian Cysts in Childhood and Adolescence: A Multicenter, Retrospective Study of 100 Patients. Journal of Pediatric and Adolescent Gynecology, 30, 449-455.
https://doi.org/10.1016/j.jpag.2017.01.011
[3]
Wu, A. and Siegel, M.J. (1987) Sonography of Pelvic Mass in Children. American Journal of Roentgenology, 148, 1199-1202. https://doi.org/10.2214/ajr.148.6.1199
[4]
Meizner, I., Levy, A., Katz, M., et al. (1991) Fetal Ovarian Cysts: Prenatal Ultrasonographic Detection and Postnatal Treatment. American Journal of Obstetrics & Gynecology, 164, 874-878. https://doi.org/10.1016/0002-9378(91)90532-V
[5]
Suila, S., Sakaguchi, T., Theda, K. and Nakano, H. (1990) Therapeutic Dilemmas Associated with Antenatally Detected Ovarian Cysts. Obstetrics & Gynecology, 171, 502-508.
[6]
Zachariou, Z., Roth, H., Boos, R., et al. (1989) Three Years’ Experience with Large Ovarian Cysts Diagnosed in Utero. Journal of Pediatric Surgery, 24, 478-482.
https://doi.org/10.1016/S0022-3468(89)80406-3
[7]
Cass, D.L., et al. (2001) Surgery for Ovarian Masses in Infants, Children, and Adolescents: 102 Consecutive Patients Treated in a 15-Year Period. Journal of Pediatric Surgery, 36, 693-699. https://doi.org/10.1053/jpsu.2001.22939
[8]
Tessiatore, P., et al. (2012) When to Operate on Ovarian Cysts in Children. Journal of Pediatric Endocrinology and Metabolism, 25, 427-433.
https://doi.org/10.1515/jpem-2012-0049
[9]
Ottmann, S.C., et al. (2010) Can We Preoperatively Risk Stratify Ovarian Masse for Malignancy? Journal of Pediatric Surgery, 45, 130-134.
https://doi.org/10.1016/j.jpedsurg.2009.10.022
[10]
Spinelli, C., et al. (2009) Hemorrhagic Corpus Luteum Cysts an Unusual Problem for Pediatric Surgeons. Journal of Pediatric and Adolescent Gynecology, 22, 163-167.
https://doi.org/10.1016/j.jpag.2008.07.013
[11]
Kirkham, Y.A. and Kives, S. (2012) Ovarian Cysts in Adolescents: Medical and Surgical Management. Adolescent Medicine: State of the Art Reviews, 23, 178-191.
https://doi.org/10.1542/9781581106497-ch11
[12]
Garel, L., Filiatrault, D., Brandt, M., et al. (1991) Antenatal Diagnosis of Ovarian Cysts: Natural History and Therapeutic Implications. Pediatric Radiology, 21, 182-184.
https://doi.org/10.1007/BF02011042
[13]
Widdowson, D.J., Pilling, D.W. and Cook, R.C.M. (1988) Neonatal Ovarian Cysts: Therapeutic Dilemma. Archives of Disease in Childhood, 63, 737-742.
https://doi.org/10.1136/adc.63.7_Spec_No.737
[14]
Grapin, C., Montagne, J.P., Sirinelli, D., et al. (1987) Diagnosis of Ovarian Cysts in the Perinatal Period and Therapeutic Implication (20 Cases). Annales de Radiologie (Paris), 30, 497-502.
[15]
Sakala, E.P., Leon, Z.A. and Rouse, G.A. (1991) Management of Antenatally Diagnosed Fetal Ovarian Cysts. Obstetrical & Gynecological Survey, 46, 407-414.
https://doi.org/10.1097/00006254-199107000-00001
[16]
Martelli, H. and Patte, C. (2003) Tumeurs des gonades chez l’enfant. Archives de Pédiatrie, 10, 246-250. https://doi.org/10.1016/S0929-693X(03)00038-1
[17]
Henrion, R. and Helardot, P.G. (1987) Le diagnostic des kystes de l’ovaire in utero. Annals of Pediatrics, 34, 65-69.
[18]
Debeugny, P., Huillet, P., Cussac, L., et al. (1989) Le traitement non opératoire systématique des kystes de l’ovaire du nouveau-né. Chirurgie Pediatrique, 30, 30-36.
[19]
Canarelli, J.P., Plancq, M.C., Bob’oyono, J.M. and Ricard, J. (1993) Kyste volumineux de l’ovaire chez l’enfant. Stratégie thérapeutique. Chirurgie (Paris), 130, 525-528.
[20]
Flamant, F., Olive, D. and Bienayme, J. (1987) Traitement des tumeurs germinales malignes de l’ovaire de l’enfant. Annals of Pediatrics (Paris), 34, 47-52.
[21]
Lardy, H. and Robert, M. (2001) Kyste de l’ovaire présumés bénins en période péri-pubertaire (10 à 16 ans). Journal of Gynecology Obstetrics and Human Reproduction 30, 4S94-4S99.
[22]
Ribault, L. and Barthe, B.L. (1989) Les tumeurs bénignes de l’ovaire chez la fillette. A propos de trois cas en Afrique. Revue française de gynécologie et d’obstétrique, 84, 443-445.
[23]
Brun, J.L., Fritel, X., Aubard, Y., et al. (2014) Management of Presumed Benign Ovarian Tumors: Updated French Guidelines. European Journal of Obstetrics & Gynecology and Reproductive Biology, 183, 52-58.
https://doi.org/10.1016/j.ejogrb.2014.10.012
[24]
Peroux, E., Franchi-Abella, S., Sainte-Croix, D., et al. (2015) Ovarian Tumors in Children and Adolescents: A Series of 41 Cases. Diagnostic and Interventional Imaging, 96, 273-282. https://doi.org/10.1016/j.diii.2014.07.001
[25]
M’pemba Loufoua-Lemay, A.B., Peko, J.F., Mokoko, J.C. and Nzingoula, S. (2003) Torsion de tumeur kystique de l’ovaire chez une adolescente, révélatrice d’un hémangiome caverneux. Archives de Pédiatrie, 10, 986-988.
https://doi.org/10.1016/j.arcped.2003.08.007
[26]
Ueland, F.R., et al. (2003) Preoperative Differentiation of Malignant from Bengn Ovarian Tumors: The Efficacy of Morphology Indexing and Doppler Flow Sonography. Gynecologic Oncology, 91, 46-50.
https://doi.org/10.1016/S0090-8258(03)00414-1
[27]
Pippo, S., Mustaniemi, L., Lenko, H., et al. (1999) Surgery for Ovarian Masses during Childhood and Adolescence: A Report of 79 Cases. Journal of Pediatric and Adolescent Gynecology, 12, 223-227.
https://doi.org/10.1016/S1083-3188(99)00020-0
[28]
Khemakhem, R., Ben Ahmed, Y., Ben Ftina, W., et al. (2012) Les kystes et tumeurs de l’ovaire chez l’enfant tunisien. Aspects diagnostiques et prise en charge thérapeutique. Journal de Pédiatrie et de Puériculture, 2, 8-13.
https://doi.org/10.1016/j.jpp.2011.11.002
[29]
Cartault, A., et al. (2012) Ovarian Masses in Adolescent Girls. Endocrine Development, 22, 194-207. https://doi.org/10.1159/000326689
[30]
Hautecoeur, W., Salame, J., De Win, B., et al. (1992) Kyste de l’ovaire néonatal: Case report et revue de la littérature. Acta Chirurgica Belgica, 92, 196-200.
[31]
Galinier, P., et al. (2009) Ovarian Torsion. Management and Ovarian Prognosis: A Report of 45 Cases. Journal of Pediatric Surgery, 44, 1759-1765.
https://doi.org/10.1016/j.jpedsurg.2008.11.058
[32]
Sarnacki, S. and Brisse, H. (2011) Surgery of Ovarian Tumors in Children. Hormone Research in Paediatrics, 75, 220-224. https://doi.org/10.1159/000322829
[33]
Chu, S.M., Ming, Y.C., Chao, H.C., et al. (2010) Ovarian Tumors in the Pediatric Group: 37 Cases Treated over an 8-Year Period. Chang Gung Medical Journal, 33, 152-156.