Functional ovarian cysts in childhood: A singlecenter experience in diagnostic and therapeutic practices

Objective: We aimed to evaluate the follow-up protocols of pediatric patients diagnosed
with functional (developmental) ovarian cysts in our hospital and to compare our approach
with findings in the literature.
Materials and methods: Medical records of 12,012 pediatric surgery outpatients
from January 2018 to December 2023 were reviewed based on ICD-10 codes. Patient
complaints, clinical history, laboratory and imaging findings, follow-up strategies, and
treatment methods were analyzed.
Results: Among 3917 female patients, 17 were diagnosed with functional ovarian cysts,
representing a prevalence of 0.15%. The mean age was 12.7 years. Seven patients were
diagnosed incidentally, seven presented with abdominal pain, one with abdominal
distention, one with a breast lesion, and one with menstrual irregularity. Hormonal tests
(Follicular stimulating hormone (FSH), Luteinizing hormone (LH), estradiol, progesterone,
prolactin) were fully performed in seven patients, partially in three, and not performed
in seven. Thirteen patients had ovarian cysts; the mean diameter was 32.2 mm in the
left ovary and 43.0 mm in the right ovary. Three patients had bilateral cysts. No medical
treatment was given. Surgery was performed in four patients—one via laparotomy for a
20 cm cyst, and three via laparoscopy. One patient declined surgery. Eight patients were
followed for an average of 1.5 years, with no additional interventions required.
Conclusion: Our pediatric surgery clinic has followed the classic algorithm for ovarian
cysts. The most remarkable finding is that ultrasound results differ conspicuously in
different centers. Our findings could be an appendix to the issue in the country.