Minimally Invasive Ovarian-Preserving Approach for the Management of a Sclerosing Stromal Tumor in an Adolescent: A Case Report

J Pediatr Adolesc Gynecol. 2022 Aug;35(4):505-508. doi: 10.1016/j.jpag.2022.01.008. Epub 2022 Feb 3.

Abstract

Background: Sclerosing stromal tumors (SSTs) are rare benign ovarian tumors that occur in adolescents and young adults. They are often treated with unilateral salpingo-oopherectomy due to concern for malignancy.

Case: A 13-year-old postpubertal female presented with sharp, constant abdominal pain with physical exam concerning for a lower abdominal mass. An ultrasound revealed a 9.7-cm solid, heterogenous left ovarian mass. The abdomen and pelvis CT confirmed the findings and showed a predominantly cystic mass arising from the left adnexa. During surgery, a smooth and distinct mass arising from the left ovary was encountered without abnormal findings in surrounding structures. A cystectomy was performed, and intraoperative findings showed no evidence of malignancy. Based on the lab, imaging, and surgical findings, staging and salpingo-oopherectomy were not pursued.

Summary and conclusion: Given the benign nature of SSTs, it is important to entertain the diagnosis in adolescents presenting with clinically congruent ovarian masses. The minimally invasive approach allows for sparing of the ovary in the adolescent population.

Keywords: Adolescent; Fertility sparing; Laparoscopy; Minimally invasive; Sclerosing stromal tumor.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Adolescent
  • Female
  • Humans
  • Ovarian Neoplasms* / diagnostic imaging
  • Ovarian Neoplasms* / surgery
  • Sex Cord-Gonadal Stromal Tumors* / pathology
  • Ultrasonography
  • Young Adult