Ovarian Tumors in Children and Adolescents

Ovarian tumors are rare in children, but a high proportion are malignant. The surgeon is important in the management, considering that healing while preserving gonadal function is fundamental. Malignant tumors could rise from any of the cellular types of the ovary, but most of them are of germinal origin. Clinical presentation could be variable but is frequent to see a painful palpable mass in the abdomen. Imaging and tumor markers are useful to better define the suspicion and help with surgical planning. If we are in front of a probably benign tumor with a cystic component, a good approach is to perform a Künstner laparotomy for careful draining and tumorectomy with gonadal preservation. An exploratory laparoscopy is then performed for staging. A minimally invasive approach could be proposed when it’s a certainty of a benign disease and the tumor is less than 6–8 cm of diameter. When the suspicion is of malignancy, the surgical approach must be a median laparotomy for a thorough exploration of the cavity, meticulous staging, and salpingo-oophorectomy.