Functional ovarian cysts in childhood: A single-center experience in diagnostic and therapeutic practices

Abstract

Objective: We aimed to evaluate the follow-up protocols of pediatric patients diagnosed with functional (developmental) ovarian cysts in our hospital and to compare our approach with findings in the literature.

Materials and methods: Medical records of 12,012 pediatric surgery outpatients from January 2018 to December 2023 were reviewed based on ICD-10 codes. Patient complaints, clinical history, laboratory and imaging findings, follow-up strategies, and treatment methods were analyzed.

Results: Among 3917 female patients, 17 were diagnosed with functional ovarian cysts, representing a prevalence of 0.15%. The mean age was 12.7 years. Seven patients were diagnosed incidentally, seven presented with abdominal pain, one with abdominal distention, one with a breast lesion, and one with menstrual irregularity. Hormonal tests (Follicular stimulating hormone (FSH), Luteinizing hormone (LH), estradiol, progesterone, prolactin) were fully performed in seven patients, partially in three, and not performed in seven. Thirteen patients had ovarian cysts; the mean diameter was 32.2 mm in the left ovary and 43.0 mm in the right ovary. Three patients had bilateral cysts.  No medical treatment was given. Surgery was performed in four patients—one via laparotomy for a 20 cm cyst, and three via laparoscopy. One patient declined surgery. Eight patients were followed for an average of 1.5 years, with no additional interventions required.

Conclusion: Our pediatric surgery clinic has followed the classic algorithm for ovarian cysts. The most remarkable finding is that ultrasound results differ conspicuously in different centers. Our findings could be an appendix to the issue in the country.