Presentation, Diagnosis, Treatment And Outcome Of Childhood Ovarian Masses At Two Nigerian Tertiary Hospitals

Abstract

Background: Ovarian tumours even though uncommon and benign in the majority of cases in children, delayed presentation, wrong diagnosis and inappropriate treatment may result in complications of an otherwise benign tumour and spread of malignant ones.
Aim: We aimed to evaluate or experience with the management of childhood ovarian masses in two Tertiary Hospital in Nigeria.
Methodology: Between July 2002 and June 2008, 36 children who were treated with ovarian masses at the University of Benin Teaching Hospital and Irrua Specialist Teaching Hospital in Edo State, Nigeria, were retrospectively studied.
Results: Ovarian masses accounted for 36 (1.3%) indications for paediatric operations and 15.1% children with paediatric surgical tumours during the period. Benign ovarian cyst 17 (47.2%), teratoma 11 (30.6%) and follicular cyst 8 (22.2%) were the causes of ovarian masses. Extra-pelvic location of many masses, late presentation, traditional treatment and the presence of complications before arrival were compounded by lack of sophisticated imaging facilities. Consequently, few cases 11 (30.6%) were correctly diagnosed preoperatively. Surgical treatment alone was curative in all children with benign lesions while a large proportion, 5 (45.5%), of those with teratoma succumbed to the illness despite combination therapy, giving 13.9% overall mortality.
Conclusion: Ovarian mass should be a differential diagnosis of mobile childhood abdominal mass irrespective of intra-abdominal location. Early referral should be encouraged as the importance of early diagnosis and treatment cannot be overemphasized.


Keywords: Childhood, Ovarian masses, Presentation, Diagnosis, Treatment, Outcome

Sahel Medical Journal Vol. 11 (3) 2008: pp. 70-74