Ovarian Cysts and Tumors in Children

What are ovarian cysts and tumors in children?

Ovarian cysts and ovarian tumors are both considered ovarian masses. These masses, which may be cancerous or noncancerous, are enlarged growths on or inside one or both of the ovaries. The ovaries are small reproductive organs located on each side of the uterus.

An ovarian cyst is a fluid-filled sac. Types of ovarian cysts include:

  • Functional cysts, which are the most common type of ovarian cysts. They form during ovulation and usually resolve on their own.
  • Dermoid cysts, which are a mixture of cysts and solid tissue growths in the ovary.

An ovarian tumor is a mass or lump of cells in the ovary. Types of ovarian tumors include:

  • Germ cell tumors, which are the most common ovarian tumors during childhood and adolescence.
  • Stromal tumors, which are uncommon tumors in childhood and adolescence.
  • Epithelial cell tumors, which are rare tumors in childhood and adolescence. They are the most common type among adult women. These tumors develop from the cells on the ovary’s outer surface.

What causes ovarian cysts in children?

Ovarian cysts are common during the most hormonally active period of development. In newborns, ovarian cysts can form due to the influence of maternal hormones. Among adolescent girls — as well as adults — cysts can form due to the monthly hormonal cycle.

What causes ovarian tumors in children?

The exact cause of pediatric ovarian tumors is unknown.

Symptoms of Ovarian Cysts and Tumors in Children

Common symptoms include:

In some cases, there are no symptoms at all.

Diagnosis of Ovarian Cysts and Tumors in Children

Ovarian cysts or tumors are usually diagnosed following an abdominal and pelvic exam, during which a mass can be detected. Additional testing can include:

Treatment for Ovarian Cysts and Tumors in Children

Treatment for cysts or tumors depends on the child’s medical situation. Some ovarian cysts show no symptoms and go away on their own.

A large ovarian cyst or tumor may pull on the pelvic ligaments and make it likely that the ovary will become twisted and very painful — a condition called ovarian torsion. Extreme pain can be an important indicator of torsion and requires emergency evaluation. The diagnosis can be confirmed by observing with a pelvic ultrasound a lack of blood flow to the ovary.

Frequently, these cases are treated with emergency surgery. Ovaries with torsion can be salvaged in most cases.

Ovarian Cyst or Tumor Surgery for Children

Surgery may be required for:

  • Large ovarian cysts
  • Cysts that are causing pain
  • Solid or mixed (solid/cystic) tumors

How is surgery for an ovarian cyst or tumor performed on children?

Surgery to remove an ovarian cyst or tumor can be done with open or laparoscopic surgery. Open surgery is usually performed through a “bikini” incision low in the abdomen that splits rather than cuts the abdominal muscles. Laparoscopic surgery is performed through small incisions in the abdomen. After placing ports in these incisions, a viewing scope and operating instruments are inserted.

Some ovarian cysts can be removed while leaving the rest of the ovary intact, and others require removing the entire ovary and fallopian tube on the affected side. In all cases, the surgeon takes great care to inspect the opposite ovary to ensure it remains in good condition. Incisions are usually closed with absorbable sutures, which are stitches made of materials that the body can absorb and so do not need to be removed.

What are the effects of removing a cyst or removing an ovary from a child?

Other than the normal process of recovering from surgery:

  • Removing a cyst while leaving the ovary intact should cause no noticeable effect.
  • Removing one ovary will not affect the function of the other ovary, as long as the remaining ovary has normal function. In these cases, hormonal effects such as menstruation, other changes from puberty and reproductive capacity should be unaffected.

Ovarian Cyst or Tumor Surgery Recovery for Children

Recovery from ovarian surgery is usually quick, and most patients are discharged the day of or the day after surgery. Patients are usually allowed oral liquid and food intake as soon as they recover from anesthesia, and they are transitioned to oral pain medications.

Physical activity is generally restricted for a few weeks after surgery, but children may return to school within a few days, once the pain subsides.

Other Treatment Options for Ovarian Cysts and Tumors

Besides surgery, the child may require other forms of treatment. These may include:

  • Chemotherapy
  • Supportive care such as medication, acupuncture or massage