Paraovarian cysts in pediatrics. Retrospective analysis of diagnostic and laparoscopic treatment in a single institution.

Purpose: This study presents a 24-year single-center experience in treating pediatric paraovarian tumors. It examines their key characteristics and discusses diagnostic and management considerations.

Methods: We performed a retrospective analysis of medical records for pediatric patients who underwent surgery for an adnexal mass from January 2000 to April 2024. The inclusion criteria were based on intraoperative diagnoses of paraovarian cysts, which were later confirmed by final surgical pathology reports.

Results: Seventy-one patients operated on for paraovarian cysts were identified. Their ages ranged from 10 to 18 years, with a median age of 15 years. The primary complaint was abdominal pain, reported by 47 patients (66%). This pain was attributed to adnexal torsion in 29 cases (41%) and the presence of a mass in 19 cases (27%). Mass effects were observed in six patients (8%). Preoperative diagnoses were correct in 52% of the cases, while intraoperative accuracy reached 99%. None of the patients showed signs of malignant transformations. The preferred surgical approach was laparoscopy, which was performed on 59 patients (83%). Adnexal-sparing surgery was conducted in 70 patients, while one patient required adnexectomy following spontaneous subtotal amputation due to torsion.

Conclusion: Accurately identifying paraovarian cysts during surgery is essential for effective management and adnexal preservation. Due to the risk of torsion, surgical intervention should be considered even for small and asymptomatic paraovarian cysts. In cases where there is uncertainty, laparoscopy is a valuable tool for both diagnosis and treatment. Laparoscopic excision is a feasible, less invasive, and safe approach to treatment.