Abstract
Purpose
To determine the features which predict torsion and the pre-operative indicators of malignancy in cases of ovarian torsion in ovarian tumors (OTs) in children.
Methods
The medical records of 35 pediatric patients who underwent surgery for OT, except for neonate cases, from 1997 to 2018 at our institution were reviewed retrospectively.
Results
The pathological diagnosis was mature teratoma in 17, immature teratoma in 9, yolk sac tumor in 3, and others in 6. The preoperative diagnosis, which was made based on the imaging findings and the serum tumor marker values, matched with the pathological diagnosis in 29/35 (83%). Ovarian torsion occurred in 14/35 (40%). All but one case that presented with torsion had intermittent abdominal pain as the primary symptom. The preoperative white blood cell count was significantly higher in cases where ovary preservation was impossible than where it was possible (p = 0.01) among the cases presenting with torsion.
Conclusion
Preoperative imaging findings and the serum tumor marker values enabled us to make an accurate preoperative diagnosis. Patients with intermittent abdominal primary symptoms were more likely to have ovarian torsion than those without such symptoms, and leukocytosis may indicate irreversible ischemic changes in the affected ovary.
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Acknowledgements
We thank Brian Quinn, Editor-in-Chief, Japan Medical Communication, for his comments and help with the manuscript.
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KM is a professor; NT and TA are trainees; HT, KN, FC, YU, and TS are staff surgeons at the Department of Pediatric Surgery, University of Tsukuba. All authors contributed to the study conception and design. HT and KM participated in the patient care, research design, performance of the study, and writing of the paper. NT, TA, TS, KO, FC, YU, and TS participated in the patient care and data collection. KM participated in the critical revision of the manuscript. All authors read and approved the final manuscript.
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The study was performed in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects by the Ministry of Health, Labour, and Welfare of Japan in 2014, in compliance with the 1964 Declaration of Helsinki (revised in 2013) and with the approval of the institutional review board of our local institute.
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Takayasu, H., Masumoto, K., Tanaka, N. et al. A clinical review of ovarian tumors in children and adolescents. Pediatr Surg Int 36, 701–709 (2020). https://doi.org/10.1007/s00383-020-04660-w
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DOI: https://doi.org/10.1007/s00383-020-04660-w