Ovarian Endometrioma: a Report of a Pediatric Case Diagnosed Prior to Menstruation

Overview

Journal Surg Case Rep

Specialty General Surgery

Date 2024 Jun 19

PMID 38898208

Authors

Lynne Takada

Takafumi Kawano

Keisuke Yano

Yumiko Iwamoto

Masato Ogata

Chihiro Kedoin

Masakazu Murakami

Koshiro Sugita

Shun Onishi

Mitsuru Muto

Mari Kirishima

Akihide Tanimoto

Satoshi Ieiri

Affiliations

Soon will be listed here.

Abstract

Background: Ovarian endometriomas (OEs) are rarely found in the pediatric population, especially before menstruation. We report a 6-year-old girl who was postoperatively diagnosed with OE before menstruation.

Case Presentation: A 6-year-old girl presented to a local pediatrician with abdominal pain and vomiting. Abdominal ultrasonography revealed a multilocular cystic lesion to the left of the bladder. Magnetic resonance imaging (MRI) revealed similar findings, with the contents of the cyst showing a low signal on T1-weighted imaging and a high signal on T2-weighted imaging. The patient was referred to our institution for further examination. Enhanced computed tomography (CT) showed a multilocular cystic lesion sized 56 × 44 × 30 mm with partial calcification. The left ovarian vein was dilated, suggesting the origin of the tumor to be the left ovary. Extirpation of the lesion was performed under laparoscopic assistance. Pathological findings indicated an ovarian endometrioma. To our knowledge, this is the youngest report of an OE diagnosed in a patient prior to menstruation.

Conclusions: OEs in children before menstruation are extremely rare; thus, the long-term prognosis is yet to be determined.

References

Unger C, Laufer M . Progression of endometriosis in non-medically managed adolescents: a case series. J Pediatr Adolesc Gynecol. 2010; 24(2):e21-3. DOI: 10.1016/j.jpag.2010.08.002. View

Fedele L, Bianchi S, Zanconato G, Bettoni G, Gotsch F . Long-term follow-up after conservative surgery for rectovaginal endometriosis. Am J Obstet Gynecol. 2004; 190(4):1020-4. DOI: 10.1016/j.ajog.2003.10.698. View

Busacca M, Vignali M . Ovarian endometriosis: from pathogenesis to surgical treatment. Curr Opin Obstet Gynecol. 2003; 15(4):321-6. DOI: 10.1097/01.gco.0000084247.09900.4f. View

Reese K, Reddy S, Rock J . Endometriosis in an adolescent population: the Emory experience. J Pediatr Adolesc Gynecol. 1996; 9(3):125-8. DOI: 10.1016/s1083-3188(96)70021-9. View

Dessole M, Melis G, Angioni S . Endometriosis in adolescence. Obstet Gynecol Int. 2012; 2012:869191. PMC: 3474254. DOI: 10.1155/2012/869191. View

Morassutto C, Monasta L, Ricci G, Barbone F, Ronfani L . Incidence and Estimated Prevalence of Endometriosis and Adenomyosis in Northeast Italy: A Data Linkage Study. PLoS One. 2016; 11(4):e0154227. PMC: 4839734. DOI: 10.1371/journal.pone.0154227. View

Gogacz M, Sarzynski M, Napierala R, Sierocinska-Sawa J, Semczuk A . Ovarian endometrioma in an 11-year-old girl before menarche: a case study with literature review. J Pediatr Adolesc Gynecol. 2011; 25(1):e5-e7. DOI: 10.1016/j.jpag.2011.09.009. View

Marsh E, Laufer M . Endometriosis in premenarcheal girls who do not have an associated obstructive anomaly. Fertil Steril. 2005; 83(3):758-60. DOI: 10.1016/j.fertnstert.2004.08.025. View

Agarwal S, Chapron C, Giudice L, Laufer M, Leyland N, Missmer S . Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol. 2019; 220(4):354.e1-354.e12. DOI: 10.1016/j.ajog.2018.12.039. View

10.

Laufer M, Sanfilippo J, Rose G . Adolescent endometriosis: diagnosis and treatment approaches. J Pediatr Adolesc Gynecol. 2003; 16(3 Suppl):S3-11. DOI: 10.1016/s1083-3188(03)00066-4. View

11.

Batt R, Mitwally M . Endometriosis from thelarche to midteens: pathogenesis and prognosis, prevention and pedagogy. J Pediatr Adolesc Gynecol. 2003; 16(6):337-47. DOI: 10.1016/j.jpag.2003.09.008. View

12.

Shafrir A, Farland L, Shah D, Harris H, Kvaskoff M, Zondervan K . Risk for and consequences of endometriosis: A critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018; 51:1-15. DOI: 10.1016/j.bpobgyn.2018.06.001. View

13.

Wright K, Laufer M . Endometriomas in adolescents. Fertil Steril. 2010; 94(4):1529.e7-1529.e9. DOI: 10.1016/j.fertnstert.2010.02.018. View