Analysis of adnexal lesions in adolescents requiring surgical treatment

Aim
To analyse data of adolescent patients operated on due to adnexal masses at Department of Operative Gynecology and Gynecologic Oncology of Polish Mother's Memorial Hospital.

Materials and methods
The data of patients below 19 years of age operated on between 1993 and 2015 were analysed. We analysed data the age, type of surgical treatment, size and histological type of adnexal masses and complications.

Results
172 adolescents were operated on; adnexal masses were identified in 141 patients. The average age of patients was 15 years (+/-2.2). Malignant lesions were diag-nosed in 6 patients. Two girls had two types of malignant lesions at the same time (gonadoblastoma and dysgerminoma, embryonal carcinoma and dysgerminoma). Benign lesions accounted for 94% of adnexal masses. Mature teratoma (31%) and serous cysts were the most common lesions. Hemorrhagic lesions and mucous cysts represent 13% and 4% of all benign lesions respectively. Oviductus lesions were diagnosed in 13% of all operated patients. Fibrothecoma, adnexal torsion and ovarian necrosis were confirm in 11% of benign masses. The avarege diameter of masses was 9.35cm (+/-5.4cm). Bilateral masses occurred in 3 patients (2%). Lesions of a smaller diameter (5.8cm +/-2.9cm) were removed by laparoscopy while laparotomy was performed to remove bigger lesions (10.35cm +/-5.5 in diameter). In one case re-laparoscopy was needed to coagulate bleeding in the lodge of a removed tumor. Two patients required conversion to laparotomy. In one case an abscess of the fallopian tube and appendicitis were confirmed. In the other patient laparoscopy was abandoned due to the suspicious character of the tumor.

Conclusion
Adnexal lesions requiring surgical treatment in adolescent are mostly unila¬teral benign ovarian cysts. The type of surgery (laparoscopy/laparotomy) mainly depends on the size and nature of an adnexal lesion.