Torsion of ovarian tumors in premenarchal and postmenarchal girls: review of 90 cases

Abstract

Objectives To investigate clinical and histological findings, and to define specific characteristics of ovarian tumors according to menarchal status in young girls

Methods We retrospectively evaluated young patients (< 18yrs old) treated for adnexal tumors during the last 23 years. Clinical presentations, age of menarche, tumor types, the frequency of torsion and pathology reports were evaluated.

Results Among 90 pts operated for an ovarian tumor, pre-menarche (BM) and post-menarche (PM) were 24 and 66 cases, respectively. Most of them complained of an abdominal pain (~70%), but any palpable mass was only identified in 17% and 30% of BM and PM, respectively. On the other hand, vomiting was one of major complaints in BM (30%), not in PM (<5%). In addition, the frequency of torsion was significantly high in BM (50%) compared with 17% in PM, and more than 90% of torsion was of germ cell origin in BM.

Conclusion The incidence of ovarian tumors and torsion is known to be very rare especially in premenarchal girls. However, our results showed that torsion was highly prevalent in premenarchal girls. Although symptoms and signs were usually nonspecific, great care should be taken for young girls with abdominal pain especially accompanied by vomiting regardless of presenting any palpable mass.