SAN DIEGO – Most ovarian cysts in adolescents will resolve, but those greater than 100 mL in size are the most predictive of ovarian pathology and need for surgical intervention.
The findings, presented during a poster session at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology, come from a study of 78 adolescent females at Children’s Mercy Hospital, Kansas City, who were given a diagnostic ICD-9 code consistent with ovarian cyst or mass between 2004 and 2012.
"There is insufficient documentation that most cysts will either decrease in size or resolve, but clear criteria for conservative management in this group has not been described," researchers led by Dr. Crystal Meacham wrote in the poster. "When indicated, laparoscopic intervention of ovarian cysts in adolescents has been well studied and is the preferred surgical approach."
In an effort to determine predictive characteristics that would aid in safe observation and expectant management versus the need for surgical intervention, Dr. Meacham and her associates limited their analysis to adolescents with ovarian cysts greater than or equal to 3 cm in largest diameter on imaging. They recorded cyst volume at initial presentation and follow-up imaging was recorded. Cysts were categorized into three groups based on size: small (0-49 mL), medium (50-100 mL), and large (greater than 100 mL).
The average cyst volume at initial imaging was 62.17 mL, while the average volume at follow-up imaging was 25.81 mL, a reduction that reached statistical significance (P is less than .0001). Of the 78 cysts, 61 (90%) resolved and 17 did not. The researchers found that cysts in the large-volume category were most likely to persist and require surgical intervention.
"Level of cyst complexity is not a predictive characteristic for ovarian cyst resolution nor an indication for surgical management," they wrote. "The pathology most consistent with cysts of the large-volume category, and thus requiring surgery, is serous cystadenoma. Large cyst volume is most predictive of ovarian pathology and need for surgical intervention."
The researchers had no relevant financial disclosures.