| Abstract | Cilj istraživanja: Patologija jajnika u dječjoj dobi je česta, ali i raznolika. Kliničke manifestacije tumora jajnika su nespecifične što stvara diferencijalno dijagnostičke tegobe pri razlikovanju tumora od drugih patoloških stanja koji se manifestiraju sličnim simptomima. Cilj ovog istraživanja je odrediti epidemiološke, demografske i kliničke karakteristike bolesnica operiranih u Klinici za dječju kirurgiju KBC-a Split zbog tumora jajnika, te ih usporediti s ostalim relevantnim studijama.
Ispitanici i metode: U vremenskom razdoblju od siječnja 2002. do lipnja 2018. retrospektivno su pregledane povijesti bolesti 72 bolesnice operirane zbog tumora jajnika. Podatke smo prikupili istraživanjem pisanog protokola Klinike za dječju kirurgiju KBC-a Split te arhive povijesti bolesti. Svakom ispitaniku su analizirani sljedeći parametri: anamnestički podaci o simptomima, dob, lateralizacija, fizikalni pregled, tumorski biljezi, operacijski nalaz, veličina tumora, patohistološki nalaz, duljina hospitalizacije te komplikacije.
Rezultati: Istraživanje je obuhvatilo 72 bolesnice, srednje dobi 14 godina, operirane zbog tumora jajnika. Tumori su se najčešće pojavljivali u dobnoj skupini od 14. do 17. godina (58.3%). Tumori su češće bili desnostrani, dok je srednja veličina gledajući najveći promjer bila 9.43 cm. Vodeći simptom je bila bol (80.56%), a slijede je povraćanje (34.78%), povišena tjelesna temperatura (15.22%), mučnina (10.87%) i nedostatak apetita (10.87%). Deset bolesnica nije imalo nikakve simptome već su tumori slučajno pronađeni. Sve bolesnice iz studije su operirane, a veći broj je podvrgnut žurnoj operaciji 46 (63.89%). Vodeći operacijski pristup je bila laparoskopija (59.72%). Radikalnim operacijskim zahvatima je podvrgnuto 19 bolesnica (adneksektomija, n=15; ovriektomija, n=4; obostrana adneksektomija, n=1). Od ukupnog broja bolesnica njih 25 je imalo torziju jajnika, koja se češće nalazila desno (72%). Torziju nepromjenjenog jajnika je imalo 12% bolesnica dok su zreli teratomi i jednostvne ciste jajnika (28%) bile najčešći tumor koji povezan s torzijom. Najčešči patohistološki tip tumora su bile jednostavne ciste jajnika (29.73%).
Zaključci: Tumori jajnika u dječjoj dobi mogu se prezentirati različitim simptomima, najčešći među njima je bol. Osim na tumor, bol može ukazivati i na torziju jajnika posebice ako je praćena povraćanjem, mučninom ili povišenom tjelesnom temperaturom. Posljedica zakašnjele dijagnoze torzije može biti nepovratno uništenje tkiva jajnika. U ovoj dobnoj skupini najčešće se radi o benignim tumorima, među kojima su najčešće ciste i zreli teratomi. |
| Abstract (english) | Objectives and background: Pediatric ovarian pathology is frequent. Clinical manifestations of ovarian tumors are nonspecific, which creates differential diagnostic problems in distinguishing tumors from other pathological conditions that manifest with similar symptoms. The aim of this study was to determine the epidemiological, demographic and clinical features of patients operated due to ovarian tumors in Split University Hospital and compare results with other relevant studies.
Patients and methods: In the period from January 2002 to June 2018 the case records of 72 patients treated for ovarian tumors were retrospectively reviewed. Data was collected from the protocols of Department of Pediatric Surgery and Split University Hospital archives. Each patient was analyzed for following parameters: anamnestic data of symptoms, age, lateralization of tumor, physical examination, tumor markers, operation finding, tumor size, pathohistological analysis, length of hospitalization and complications.
Results: The study included 72 patients, median of age 14 years, operated due to ovarian tumors. Tumors were most common in the age group 14 to 17 (58.3%). Tumors were more common on the right ovary, while the median size was 9.43 cm in diameter. The leading symptom was pain (80.56%) followed by vomiting (34.78%), elevated body temperature (15.22%), nausea (10.87%) and lack of appetite (10.87%). Ten patients did not have any symptoms but the tumors were accidentally founded. All the patients in the study were operated, and a greater number underwent urgent surgery 46 (63.89%). The leading operative approach was laparoscopy (59.72%). Nineteen patients underwent radical surgery (adnexectomy, n=15; ovariectomy, n=4; bilateral adnexectomy, n=1). Of the total number of patients, 25 had an ovarian torsion, which was more common on right side (72%). Three (12%) patients had torsion of ovary without associated tuor, while mature teratomas and simple ovarian cysts (28%) were the most common tumors associated with torsion. The most common pathohistological types of tumors were simple ovarian cysts (29.73%).
Conclusions: Ovarian tumors in childhood can be presented with various symptoms, most common among them is pain. Apart from the tumor, pain may also indicate ovarian torsion, especially if accompanied by vomiting, nausea, or elevated body temperature. The consequence of late diagnosis of torsion can be irreversible destruction of ovarian tissue. The most common tumors in this age group are ovarian cysts, followed by mature teratomas. |
