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Clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients
This study investigated the clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients. Our objective was to better define the clinical presentation of adnexal torsion and to distinguish characteristics of those with torsion and th...
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| Published in: | Orphanet journal of rare diseases 2024-03, Vol.19 (1), p.132-132, Article 132 |
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| creator | Liu, Qian Li, Zhiqiang Zhou, Huimei Cao, Dongyan Yang, Jiaxin Shen, Keng Lang, Jinghe |
| description | This study investigated the clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients. Our objective was to better define the clinical presentation of adnexal torsion and to distinguish characteristics of those with torsion and those with an alternate diagnosis.
Retrospective cohort study of 212 pediatric and adolescent patients was performed who admitted for abdominal pain and presenting with an adnexal mass between March 2012 to December 2019.Medical records were reviewed for age at operation, including presentation of symptoms and signs; the levels of tumor markers; imaging examinations; pathologic findings; the size of masses; treatment; and outcome. Data management and descriptive analyses were performed using SPSS 26.0.
The median age of the patients was 14.5 ± 3.6 years at the operation. 126 (59.4%, 126/212) patients presented with an abrupt onset of abdominal pain. A total of 82.1% (174/212) of the participants underwent adnexal conservative surgery. 179 (84.5%, 179/212) patients underwent laparoscopic surgery with an average tumor size of 7.7 ± 3.4 cm, while 33 patients ( 15.6%, 33/212) underwent laparotomy. Rupture of mass and ectopic pregnancy accounted for 7.5% (16/212) and 0.9%(2/212), respectively. Torsion was responsible for 36.8% (78/212) of all patients. Among the patients with torsion, the symptom of nausea and vomiting was more common among girls without torsion (P |
| doi_str_mv | 10.1186/s13023-024-03101-4 |
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Retrospective cohort study of 212 pediatric and adolescent patients was performed who admitted for abdominal pain and presenting with an adnexal mass between March 2012 to December 2019.Medical records were reviewed for age at operation, including presentation of symptoms and signs; the levels of tumor markers; imaging examinations; pathologic findings; the size of masses; treatment; and outcome. Data management and descriptive analyses were performed using SPSS 26.0.
The median age of the patients was 14.5 ± 3.6 years at the operation. 126 (59.4%, 126/212) patients presented with an abrupt onset of abdominal pain. A total of 82.1% (174/212) of the participants underwent adnexal conservative surgery. 179 (84.5%, 179/212) patients underwent laparoscopic surgery with an average tumor size of 7.7 ± 3.4 cm, while 33 patients ( 15.6%, 33/212) underwent laparotomy. Rupture of mass and ectopic pregnancy accounted for 7.5% (16/212) and 0.9%(2/212), respectively. Torsion was responsible for 36.8% (78/212) of all patients. Among the patients with torsion, the symptom of nausea and vomiting was more common among girls without torsion (P < 0.0001). 88.5% of the girls with torsion had acute onset of abdominal pain, while 92.3% had persistent pain that could not be relieved or occurred repeatedly, which significantly higher than that in the patients without torsion (P < 0.001). 69.2% of patients with torsion had fixed pain sites, compared with 42.2% in patients without torsion (P < 0.001). 88.5% of girls with torsion had an ovarian cyst/mass ≥ 5 cm, compared with 75.0% in girls without torsion (P = 0.038). 66.7% of girls underwent ovary-preserving surgery, compared with 92.2% in patients without torsion. The most common pathologic types were mature teratoma and simple cyst, accounting for 29.4% and 25.6%, respectively. The multivariate analyses confirmed that mass size greater than 5 cm (OR 4.134, 95% CI: 1.349-12.669,P = 0.013), acute onset pain (OR 24.150,95%CI: 8.398-69.444,P = 0.000), persistent or recurrent pain (OR 15.911,95%CI: 6.164-41.075,P = 0.000) were significantly associated with increased risk of torsion.
Torsion which is a relatively rare event in the pediatric population was not an uncommon condition and responsible for more than one third of all pediatric and adolescent patients presented with adnexal masses and abdominal pain. Pain assessment in children and adolescents is important to distinguish characteristics of those with torsion and those with an alternate diagnosis.Thus, pediatric and adolescent patients particularly with a pelvic mass size greater than 5 cm, acute onset pain, persistent or recurrent pain have a benign cause and not missing the devastating condition that needs emergent attention. Thus, a strategy of earlier and liberal use of Diagnostic Laparoscopy (DL) may improve ovarian salvage.</description><identifier>ISSN: 1750-1172</identifier><identifier>EISSN: 1750-1172</identifier><identifier>DOI: 10.1186/s13023-024-03101-4</identifier><identifier>PMID: 38515195</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Abdomen ; Abdominal pain ; Adnexitis ; Adolescent ; Appendicitis ; Biomarkers ; Care and treatment ; Causes of ; Chemotherapy ; Cysts ; Demographic aspects ; Development and progression ; Diagnosis ; Ectopic pregnancy ; Fertility ; Laparoscopy ; Laparotomy ; Magnetic resonance imaging ; Management science ; Medical records ; Medical research ; Medicine, Experimental ; Menstruation ; Nausea ; Ovarian mass ; Ovaries ; Pain ; Pathology ; Patients ; Pediatric ; Pediatrics ; Pregnancy complications ; Regression analysis ; Steroids ; Surgery ; Teenagers ; Teratoma ; Tomography ; Tumor markers ; Tumors ; Ultrasonic imaging ; Vomiting</subject><ispartof>Orphanet journal of rare diseases, 2024-03, Vol.19 (1), p.132-132, Article 132</ispartof><rights>2024. The Author(s).</rights><rights>COPYRIGHT 2024 BioMed Central Ltd.</rights><rights>2024. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c493t-a2d7b17136bdacf151b8b2df0083221f9b9d7054bcf93b3b22ce3656ec8fe1c3</cites><orcidid>0000-0003-0049-4656</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/3037875140?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,25753,27924,27925,37012,37013,44590</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38515195$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Qian</creatorcontrib><creatorcontrib>Li, Zhiqiang</creatorcontrib><creatorcontrib>Zhou, Huimei</creatorcontrib><creatorcontrib>Cao, Dongyan</creatorcontrib><creatorcontrib>Yang, Jiaxin</creatorcontrib><creatorcontrib>Shen, Keng</creatorcontrib><creatorcontrib>Lang, Jinghe</creatorcontrib><title>Clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients</title><title>Orphanet journal of rare diseases</title><addtitle>Orphanet J Rare Dis</addtitle><description>This study investigated the clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients. Our objective was to better define the clinical presentation of adnexal torsion and to distinguish characteristics of those with torsion and those with an alternate diagnosis.
Retrospective cohort study of 212 pediatric and adolescent patients was performed who admitted for abdominal pain and presenting with an adnexal mass between March 2012 to December 2019.Medical records were reviewed for age at operation, including presentation of symptoms and signs; the levels of tumor markers; imaging examinations; pathologic findings; the size of masses; treatment; and outcome. Data management and descriptive analyses were performed using SPSS 26.0.
The median age of the patients was 14.5 ± 3.6 years at the operation. 126 (59.4%, 126/212) patients presented with an abrupt onset of abdominal pain. A total of 82.1% (174/212) of the participants underwent adnexal conservative surgery. 179 (84.5%, 179/212) patients underwent laparoscopic surgery with an average tumor size of 7.7 ± 3.4 cm, while 33 patients ( 15.6%, 33/212) underwent laparotomy. Rupture of mass and ectopic pregnancy accounted for 7.5% (16/212) and 0.9%(2/212), respectively. Torsion was responsible for 36.8% (78/212) of all patients. Among the patients with torsion, the symptom of nausea and vomiting was more common among girls without torsion (P < 0.0001). 88.5% of the girls with torsion had acute onset of abdominal pain, while 92.3% had persistent pain that could not be relieved or occurred repeatedly, which significantly higher than that in the patients without torsion (P < 0.001). 69.2% of patients with torsion had fixed pain sites, compared with 42.2% in patients without torsion (P < 0.001). 88.5% of girls with torsion had an ovarian cyst/mass ≥ 5 cm, compared with 75.0% in girls without torsion (P = 0.038). 66.7% of girls underwent ovary-preserving surgery, compared with 92.2% in patients without torsion. The most common pathologic types were mature teratoma and simple cyst, accounting for 29.4% and 25.6%, respectively. The multivariate analyses confirmed that mass size greater than 5 cm (OR 4.134, 95% CI: 1.349-12.669,P = 0.013), acute onset pain (OR 24.150,95%CI: 8.398-69.444,P = 0.000), persistent or recurrent pain (OR 15.911,95%CI: 6.164-41.075,P = 0.000) were significantly associated with increased risk of torsion.
Torsion which is a relatively rare event in the pediatric population was not an uncommon condition and responsible for more than one third of all pediatric and adolescent patients presented with adnexal masses and abdominal pain. Pain assessment in children and adolescents is important to distinguish characteristics of those with torsion and those with an alternate diagnosis.Thus, pediatric and adolescent patients particularly with a pelvic mass size greater than 5 cm, acute onset pain, persistent or recurrent pain have a benign cause and not missing the devastating condition that needs emergent attention. Thus, a strategy of earlier and liberal use of Diagnostic Laparoscopy (DL) may improve ovarian salvage.</description><subject>Abdomen</subject><subject>Abdominal pain</subject><subject>Adnexitis</subject><subject>Adolescent</subject><subject>Appendicitis</subject><subject>Biomarkers</subject><subject>Care and treatment</subject><subject>Causes of</subject><subject>Chemotherapy</subject><subject>Cysts</subject><subject>Demographic aspects</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Ectopic pregnancy</subject><subject>Fertility</subject><subject>Laparoscopy</subject><subject>Laparotomy</subject><subject>Magnetic resonance imaging</subject><subject>Management science</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Menstruation</subject><subject>Nausea</subject><subject>Ovarian mass</subject><subject>Ovaries</subject><subject>Pain</subject><subject>Pathology</subject><subject>Patients</subject><subject>Pediatric</subject><subject>Pediatrics</subject><subject>Pregnancy complications</subject><subject>Regression analysis</subject><subject>Steroids</subject><subject>Surgery</subject><subject>Teenagers</subject><subject>Teratoma</subject><subject>Tomography</subject><subject>Tumor markers</subject><subject>Tumors</subject><subject>Ultrasonic imaging</subject><subject>Vomiting</subject><issn>1750-1172</issn><issn>1750-1172</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkl2L1DAUhoso7rr6B7yQgjd60TUf7bS9XAY_BhYE3ftwkpzMZmibMUlxvfKve2a6ro5IAgkvz3mTnLxF8ZKzS8671bvEJROyYqKumOSMV_Wj4py3Das4b8Xjv_ZnxbOUdozVjWTd0-JMdg1veN-cFz_Xg5-8CXvIt2EIW29gKB1CniOmEiZbpjku6j4Gg_aoB1eCnfCO1BFSIuW7z7claBtGPx1Y8FNJc4_WQ47eHK3AhgGTwSkTkD2t6XnxxMGQ8MX9elHcfHh_s_5UXX_-uFlfXVem7mWuQNhW85bLlbZgHF1ed1pYx1gnheCu171tWVNr43qppRbCoFw1KzSdQ27kRbFZbG2AndpHP0L8oQJ4dRRC3CqI2ZsBlTTQrCxNBlDrGkFD51rrUHcCZAPk9WbxooZ8mzFlNXp61DDAhGFOSvRtzRiTsif09T_oLsyRGpSUZLLt2obX7A-1BTrfTy7kCOZgqq6IoV_krCXq8j8UDYsjfeCEzpN-UvD2pICYjHd5C3NKavP1yykrFtbEkFJE99AjztQhbGoJm6KwqWPYVE1Fr-5fN-sR7UPJ73TJXxqTz70</recordid><startdate>20240321</startdate><enddate>20240321</enddate><creator>Liu, Qian</creator><creator>Li, Zhiqiang</creator><creator>Zhou, Huimei</creator><creator>Cao, Dongyan</creator><creator>Yang, Jiaxin</creator><creator>Shen, Keng</creator><creator>Lang, Jinghe</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISR</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0049-4656</orcidid></search><sort><creationdate>20240321</creationdate><title>Clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients</title><author>Liu, Qian ; Li, Zhiqiang ; Zhou, Huimei ; Cao, Dongyan ; Yang, Jiaxin ; Shen, Keng ; Lang, Jinghe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c493t-a2d7b17136bdacf151b8b2df0083221f9b9d7054bcf93b3b22ce3656ec8fe1c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdomen</topic><topic>Abdominal pain</topic><topic>Adnexitis</topic><topic>Adolescent</topic><topic>Appendicitis</topic><topic>Biomarkers</topic><topic>Care and treatment</topic><topic>Causes of</topic><topic>Chemotherapy</topic><topic>Cysts</topic><topic>Demographic aspects</topic><topic>Development and progression</topic><topic>Diagnosis</topic><topic>Ectopic pregnancy</topic><topic>Fertility</topic><topic>Laparoscopy</topic><topic>Laparotomy</topic><topic>Magnetic resonance imaging</topic><topic>Management science</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Menstruation</topic><topic>Nausea</topic><topic>Ovarian mass</topic><topic>Ovaries</topic><topic>Pain</topic><topic>Pathology</topic><topic>Patients</topic><topic>Pediatric</topic><topic>Pediatrics</topic><topic>Pregnancy complications</topic><topic>Regression analysis</topic><topic>Steroids</topic><topic>Surgery</topic><topic>Teenagers</topic><topic>Teratoma</topic><topic>Tomography</topic><topic>Tumor markers</topic><topic>Tumors</topic><topic>Ultrasonic imaging</topic><topic>Vomiting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Qian</creatorcontrib><creatorcontrib>Li, Zhiqiang</creatorcontrib><creatorcontrib>Zhou, Huimei</creatorcontrib><creatorcontrib>Cao, Dongyan</creatorcontrib><creatorcontrib>Yang, Jiaxin</creatorcontrib><creatorcontrib>Shen, Keng</creatorcontrib><creatorcontrib>Lang, Jinghe</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Orphanet journal of rare diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Qian</au><au>Li, Zhiqiang</au><au>Zhou, Huimei</au><au>Cao, Dongyan</au><au>Yang, Jiaxin</au><au>Shen, Keng</au><au>Lang, Jinghe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients</atitle><jtitle>Orphanet journal of rare diseases</jtitle><addtitle>Orphanet J Rare Dis</addtitle><date>2024-03-21</date><risdate>2024</risdate><volume>19</volume><issue>1</issue><spage>132</spage><epage>132</epage><pages>132-132</pages><artnum>132</artnum><issn>1750-1172</issn><eissn>1750-1172</eissn><abstract>This study investigated the clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients. Our objective was to better define the clinical presentation of adnexal torsion and to distinguish characteristics of those with torsion and those with an alternate diagnosis.
Retrospective cohort study of 212 pediatric and adolescent patients was performed who admitted for abdominal pain and presenting with an adnexal mass between March 2012 to December 2019.Medical records were reviewed for age at operation, including presentation of symptoms and signs; the levels of tumor markers; imaging examinations; pathologic findings; the size of masses; treatment; and outcome. Data management and descriptive analyses were performed using SPSS 26.0.
The median age of the patients was 14.5 ± 3.6 years at the operation. 126 (59.4%, 126/212) patients presented with an abrupt onset of abdominal pain. A total of 82.1% (174/212) of the participants underwent adnexal conservative surgery. 179 (84.5%, 179/212) patients underwent laparoscopic surgery with an average tumor size of 7.7 ± 3.4 cm, while 33 patients ( 15.6%, 33/212) underwent laparotomy. Rupture of mass and ectopic pregnancy accounted for 7.5% (16/212) and 0.9%(2/212), respectively. Torsion was responsible for 36.8% (78/212) of all patients. Among the patients with torsion, the symptom of nausea and vomiting was more common among girls without torsion (P < 0.0001). 88.5% of the girls with torsion had acute onset of abdominal pain, while 92.3% had persistent pain that could not be relieved or occurred repeatedly, which significantly higher than that in the patients without torsion (P < 0.001). 69.2% of patients with torsion had fixed pain sites, compared with 42.2% in patients without torsion (P < 0.001). 88.5% of girls with torsion had an ovarian cyst/mass ≥ 5 cm, compared with 75.0% in girls without torsion (P = 0.038). 66.7% of girls underwent ovary-preserving surgery, compared with 92.2% in patients without torsion. The most common pathologic types were mature teratoma and simple cyst, accounting for 29.4% and 25.6%, respectively. The multivariate analyses confirmed that mass size greater than 5 cm (OR 4.134, 95% CI: 1.349-12.669,P = 0.013), acute onset pain (OR 24.150,95%CI: 8.398-69.444,P = 0.000), persistent or recurrent pain (OR 15.911,95%CI: 6.164-41.075,P = 0.000) were significantly associated with increased risk of torsion.
Torsion which is a relatively rare event in the pediatric population was not an uncommon condition and responsible for more than one third of all pediatric and adolescent patients presented with adnexal masses and abdominal pain. Pain assessment in children and adolescents is important to distinguish characteristics of those with torsion and those with an alternate diagnosis.Thus, pediatric and adolescent patients particularly with a pelvic mass size greater than 5 cm, acute onset pain, persistent or recurrent pain have a benign cause and not missing the devastating condition that needs emergent attention. Thus, a strategy of earlier and liberal use of Diagnostic Laparoscopy (DL) may improve ovarian salvage.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>38515195</pmid><doi>10.1186/s13023-024-03101-4</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-0049-4656</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Abdominal pain Adnexitis Adolescent Appendicitis Biomarkers Care and treatment Causes of Chemotherapy Cysts Demographic aspects Development and progression Diagnosis Ectopic pregnancy Fertility Laparoscopy Laparotomy Magnetic resonance imaging Management science Medical records Medical research Medicine, Experimental Menstruation Nausea Ovarian mass Ovaries Pain Pathology Patients Pediatric Pediatrics Pregnancy complications Regression analysis Steroids Surgery Teenagers Teratoma Tomography Tumor markers Tumors Ultrasonic imaging Vomiting |
| title | Clinicopathological features and surgical procedures of adnexal masses with abdominal pain in pediatric and adolescent patients |
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