Ovarian and fallopian tube pathologies in children and adolescents

The aim of this study was to review ovarian and fallopian tube pathologies in Children's Clinical University Hospital (CCHU) in order to characterize their histological types and underlaying genetical pathologies. The hospital records of phenotypically female patients operated for ovarian and fallopian tube pathologies between 2016-2020 in CCHU were analyzed retrospectively. Clinical data and pathological diagnosis were obtained from medical records. 156 phenotypically female patients aged from 18 days to 22 years, were operated due to ovarian or fallopian tube pathologies. 43 cases (27,56%) were paratubal/paraovarian cysts, 36(23, 8%)- mature cystic teratomas , 17 (10,90%) -follicular cysts 10,90%, 16 (10,26%)- serous cystadenomas, 5(3,21%)- corpus luteum cysts, 7 (4,49%)- mucinous cystadenomas, 3 ( 1,92%)- fibromas, including bilateral giant calcified and ossified ovarian fibroma, 2(1,28%)- ectopic tubal pregnancy, 1 (0,64%)- serous borderline tumour, 2 (1,28%)-gonadoblastomas, 1 (0,64%)- dysgerminoma, 1(0,64%) -juvenile granulosa cell tumour In 1 case (0,64%) combined pathology of streak gonads, gonadoblastoma and dysgerminoma was found. In 6 cases (3,85%) streak gonads without signs of neoplasia were found. In 4 cases of streak gonads patients had Swyer syndrome (karyotype 46XY), in two cases karyotype was 46XX (1 case of Mayer-Rokitansky-Küster-Hauser syndrome and 1 case of primary gonadal dysgenesis).Both gonadoblastoma cases and and combined pathology case also were associated with Swyer syndrome. In total there were 7 (4,49%) Swyer syndrome cases. In 1 case (0,64%) histology revealed testicular tissue (case of androgen insensitivity syndrome). In 1 case normal ovarian tissue was found (biopsy was taken because of clinical signs of disorder of sex development). Other pathologies found included hydrosalpinx, non-specific inflammation and complete necrosis. The most common fallopian tube and ovarian pathologies in childhood are paraovarian cysts, malignant ovarian neoplasms are rare in this age group. Underlaying genetic pathologies, especially Swyer syndrome, are important in pathogenesis of ovarian pathology in childhood.