PDF(Pubmed)
Abstract：
Most abdominal masses in the pediatric population derive from the ovaries. Ovarian masses can occur in all ages, although their incidence, clinical presentation and histological distribution vary among different age groups. Children and adolescents may develop non-neoplastic ovarian lesions, such as functional cysts, endometrioma, torsion, abscess and lymphangioma as well as neoplasms, which are divided into germ cell, epithelial, sex-cord stromal and miscellaneous tumors. Germ cell tumors account for the majority of ovarian neoplasms in the pediatric population, while adults most frequently present with epithelial tumors. Mature teratoma is the most common ovarian neoplasm in children and adolescents, whereas dysgerminoma constitutes the most frequent ovarian malignancy. Clinical manifestations generally include abdominal pain, palpable mass, nausea/vomiting and endocrine alterations, such as menstrual abnormalities, precocious puberty and virilization. During the investigation of pediatric ovarian masses, the most important objective is to evaluate the likelihood of malignancy since the management of benign and malignant lesions is fundamentally different. The presence of solid components, large size and heterogenous appearance on transabdominal ultrasonography, magnetic resonance imaging and computed tomography indicate an increased risk of malignancy. Useful tumor markers that raise concern for ovarian cancer in children and adolescents include alpha-fetoprotein, lactate dehydrogenase, beta subunit of human chorionic gonadotropin, cancer antigen 125 and inhibin. However, their serum levels can neither confirm nor exclude malignancy. Management of pediatric ovarian masses needs to be curative and, when feasible, function-preserving and minimally invasive. Children and adolescents with an ovarian mass should be treated in specialized centers to avoid unnecessary oophorectomies and ensure the best possible outcome.
摘要：
儿科人群中大多数腹部肿块来自卵巢。卵巢肿块可以发生在所有年龄段，虽然它们的发病率，不同年龄组的临床表现和组织学分布不同.儿童和青少年可能发展为非肿瘤性卵巢病变，如功能性囊肿，子宫内膜瘤,扭转,脓肿和淋巴管瘤以及肿瘤，它们被分成生殖细胞，上皮，性索间质和其他肿瘤。生殖细胞肿瘤占儿科人群卵巢肿瘤的大多数，而成人最常出现上皮肿瘤。成熟畸胎瘤是儿童和青少年最常见的卵巢肿瘤，而无性细胞瘤是最常见的卵巢恶性肿瘤。临床表现一般包括腹痛、可触及的肿块,恶心/呕吐和内分泌改变，如月经异常，性早熟和男性化。在对小儿卵巢肿块的调查中，最重要的目标是评估恶性病变的可能性，因为良性和恶性病变的处理根本不同。固体成分的存在，经腹超声检查的大尺寸和不均匀外观，磁共振成像和计算机断层扫描显示恶性肿瘤风险增加.在儿童和青少年中引起卵巢癌关注的有用肿瘤标志物包括甲胎蛋白，乳酸脱氢酶,人绒毛膜促性腺激素β亚基，癌症抗原125和抑制素。然而,他们的血清水平既不能确认也不能排除恶性肿瘤.小儿卵巢肿块的管理需要治愈，在可行的情况下，功能保持和微创。患有卵巢肿块的儿童和青少年应在专门的中心进行治疗，以避免不必要的卵巢切除术并确保最佳结果。
