Adnexal Masses in Adolescents and Young Women; An Analysis Of 56 Clinical Cases
Background; Epidemiology and histopathology of adnexal masses in adolescents and young girls is different from adult and elderly women. Majority of masses are benign in nature, warranting careful fertility preserving surgical treatment plan in young age different from adult population.
Objective; To identify the prevalence, clinical presentation and distribution of various histological subtypes of ovarian tumors in adolescents and young women and secondarily, to evaluate the surgical management with reference to ovarian sparing procedures.
Methodology; A retrospective, descriptive study conducted in Obs/Gynae dept of Benazir Bhutto Hospital, Rawalpindi from January 2018-December 2019. Medical records of included patients were reviewed for; age, clinical presentation, size/ site of adnexal mass, family history, tumor markers, imaging techniques done, histological report and final treatment. Data was analyzed using SPSS version 22. Quantitative data measured in Mean/ SD and Qualitative data expressed as Frequency/Percentage.
Results; Total cases reviewed in study period were n=56 (prevalence; 2.8%). Mean age was 25.6 yrs. Lower abdominal pain was the commonest presenting symptom (36%) followed by menstrual abnormalities (30%) and dysmenorrhoe (11%). Mean tumor size was 9.2cm; Unilateral tumor in 89% and bilateral in 11%. Tumor markers were normal in 58%. Raised were; Ca-125 (20%), LDH (11%), Ca-125 + LDH (4%), HCG (2%), HCG+ LDH (5%). Five patients got LAMA, 04 got medical treatment and 47 received surgical treatment. Majority of tumors (98%) were benign and of surface epithelial origin (69%). The commonest histological type of tumor in adolescent girls was simple follicular cyst in 43% (3/7) and in young women it was serous cyst adenoma 30% (12/40).
Conclusion; Adnexal masses are common in adolescents and young females. They have wide spectrum of clinical presentation and histological subtype varies according to age. As majority is benign, ovarian sparing surgery should be offered to young women.
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