Evaluation and Management of Adnexal Masses in the Pediatric and Adolescent Population

Background: Adnexal masses are commonly encountered in the pediatric and adolescent patient population. These can represent functional ovarian cysts, benign ovarian neoplasms, paratubal cysts, tubo-ovarian abscesses, or malignant neoplasms, among others. In this patient population the majority of adnexal masses are benign. However, providers should be familiar with signs, symptoms and imaging findings regarding malignancy as well as for surgical emergencies, such as adnexal torsion. Results: Findings regarding malignancy include large cyst size, presence of thick septations, large solid components or papillary projections on ultrasonography. Providers should collaborate with experts in the management of gynecologic cancers in this age group when there is a concern for malignancy. Adnexal torsion is a surgical emergency and should be suspected in any young female with an adnexal mass and acute onset of severe abdominal pain. Conclusion: Management of adnexal masses in pediatric and adolescent females should focus on preservation of the adnexa when possible.