Purpose or Case Report: Pediatric ovarian masses, though uncommon, represent an important subset of gynaecologic pathology in children and adolescents. This review aims to provide a comprehensive overview of the imaging features of pediatric ovarian masses. There are a myriad of pediatric ovarian lesions comprising benign and malignant masses as well as non-neoplastic lesions. While non-neoplastic lesions such as functional or hemorrhagic cysts, torsion, and tubo-ovarian abscesses predominate in incidence, germ cell and sex cord–stromal tumours account for the majority of ovarian malignancies in this age group. Early detection and characterization of these lesions using multimodal imaging techniques help in optimising management, avoiding unnecessary interventions and preserving future fertility in affected children.
Methods & Materials: Pediatric ovarian masses detailed in this educational poster are illustrated using ultrasound, CT, and MRI. Imaging findings that aid to distinguish benign and malignant masses and specific features of each lesion are discussed.
Results: The pictorial review will be an illustrative review of pediatric ovarian masses with pathological correlation. An overview of imaging features that distinguish neoplastic from non-neoplastic lesions will be provided along with imaging findings that are specific to certain lesions. The benign lesions that will be discussed include functional cysts and hemorrhagic cysts, tubo-ovarian abscess, and ovarian torsion. The neoplastic lesions that will be shown are as follows: germ cell tumours including mature and immature teratoma, dysgerminoma, yolk sac tumour; surface epithelial cell tumours including serous and mucinous cystadenomas; sex-cord stromal tumours including granulosa cell tumours, Sertoli and Leydig cell tumours; and miscellaneous tumours such as rhabdomyosarcoma will be discussed. A multimodality approach will be utilised and will include ultrasound, CT, and MRI.
Conclusions: Imaging plays a key role in early detection and characterization of a wide variety of pediatric ovarian masses. A systematic imaging strategy beginning with ultrasound and supplemented with MRI forms the cornerstone of pediatric ovarian mass evaluation. Integration of imaging findings with clinical features and tumour markers not only facilitates accurate diagnosis but also guides individualized, fertility-preserving management.