@article {10569, title = {Pediatric Ovarian Torsion and its Recurrence: A Multicenter Study.}, journal = {J Pediatr Adolesc Gynecol}, volume = {30}, year = {2017}, month = {2017 Jun}, pages = {413-417}, abstract = {

STUDY OBJECTIVE: To report results of a retrospective multicentric Italian survey concerning the management of pediatric ovarian torsion (OT) and its recurrence.

DESIGN: Multicenter retrospective cohort study.

SETTING: Italian Units of Pediatric Surgery.

PARTICIPANTS: Participants were female aged 1-14~years of age with surgically diagnosed OT between 2004 and~2014.

INTERVENTIONS: Adnexal detorsion, adnexectomy, mass excision using laparoscopy or laparotomy. Different kinds of oophoropexy (OPY) for OT or recurrence, respectively.

MAIN OUTCOME MEASURES: A total of 124 questionnaires were returned and analyzed to understand the current management of pediatric OT and its recurrence. The questionnaires concerned patient age, presence of menarche, OT site, presence and type of mass, performed procedure, OPY technique adopted, intra- and postoperative complications, recurrence and site, procedure performed for recurrence, OPY technique for recurrence, and 1~year follow-up of detorsed ovaries.

RESULTS: Mean age at surgery was 9.79~{\textpm}~3.54~years. Performed procedures were open adnexectomy (52 of 125; 41.6\%), laparoscopic adnexectomy~(25 of 125; 20\%), open detorsion (10 of 125; 8\%), and laparoscopic detorsion (38 of 125; 30.4\%). Recurrence occurred in 15 of 125 cases (12\%) and resulted as~significant (P~=~.012) if associated with a normal ovary at the first episode of torsion. Recurrence occurred only in 1 of 19 cases after OPY (5.2\%). Ultrasonographic results of detorsed ovaries were not significant whether an OPY was performed or not (P~=~1.00).

CONCLUSION: Unfortunately, oophorectomy and open technique are still widely adopted even if not advised. Recurrence is not rare and the risk is greater in patients without ovarian masses. OPY does not adversely affect ultrasonographic results at 1~year. When possible OPY should be performed at the first episode of OT.

}, keywords = {Adolescent, Child, Child, Preschool, Cohort Studies, Female, Humans, Infant, Italy, Laparoscopy, Laparotomy, Menarche, Ovarian Diseases, Ovariectomy, Postoperative Complications, Recurrence, Retrospective Studies, Surveys and Questionnaires, Torsion Abnormality}, issn = {1873-4332}, doi = {10.1016/j.jpag.2016.11.008}, author = {Bertozzi, Mirko and Esposito, Ciro and Vella, Claudio and Briganti, Vito and Zampieri, Nicola and Codrich, Daniela and Ubertazzi, Michele and Trucchi, Alessandro and Magrini, Elisa and Battaglia, Sonia and Bini, Vittorio and Conighi, Maria Luisa and Gulia, Caterina and Farina, Alessandra and Camoglio, Francesco Saverio and Rigamonti, Waifro and Gamba, Piergiorgio and Riccipetitoni, Giovanna and Chiarenza, Salvatore Fabio and Inserra, Alessandro and Appignani, Antonino} } @article {8051, title = {Mature and immature teratoma: A report from the second Italian pediatric study.}, journal = {Pediatr Blood Cancer}, volume = {62}, year = {2015}, month = {2015 Jul}, pages = {1202-8}, abstract = {

BACKGROUND: Teratomas demonstrate a benign clinical behavior, however they may recur with malignant components or as teratoma, and in a small group of patients prognosis could be fatal. After the first Italian study, we collected cases of teratoma, alongside the protocol for malignant germ cell tumors.

PROCEDURE: Patients with teratoma were collected from 2004 to 2014. Teratomas were classified according to the WHO classifications, as mature and immature. Patients with pathological aFP and/or bHCG, and those with a malignant germ cell component were not included.

RESULTS: The study enrolled 219 patients (150 mature, 69 immature teratomas) with a median age at diagnosis of 42 months. The primary sites involved were: 118 gonadal and 101 extragonadal teratomas. Two females with ovarian teratoma had a positive family history. Complete and incomplete surgeries were performed in 85\% and 9\% of cases. Seventeen events occurred: six females had a second metachronous tumor (5 contralateral ovarian teratoma, 1 adrenal neuroblastoma) and 11 teratomas relapsed/progressed (3 mature, 8 immature teratomas). Two patients died, one of progressive immature teratoma and one of surgical complications. At a median follow up of 68 months, the event-free, relapse-free, and overall survival rates were 90.6\%, 94.3\%, 98.6\%, respectively.

CONCLUSIONS: Teratomas show a good prognosis, especially the mature ones: surgery and follow-up remain the standard approach. Incomplete surgery in immature teratoma is the group at greatest risk of relapse. Bilateral ovarian tumors are a possibility, and the rare family predisposition to ovarian mature teratoma warrants further analyses.

}, keywords = {Adolescent, Adult, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Incidence, Infant, Infant, Newborn, Italy, Male, Neoplasm Grading, Neoplasm Recurrence, Local, Neoplasm Staging, Neoplasms, Second Primary, Neuroblastoma, Ovarian Neoplasms, Prognosis, Prospective Studies, Survival Rate, Teratoma, Testicular Neoplasms, Young Adult}, issn = {1545-5017}, doi = {10.1002/pbc.25423}, author = {Terenziani, Monica and D{\textquoteright}Angelo, Paolo and Inserra, Alessandro and Boldrini, Renata and Bisogno, Gianni and Babbo, Gian Luca and Conte, Massimo and Dall{\textquoteright} Igna, Patrizia and De Pasquale, Maria Debora and Indolfi, Paolo and Piva, Luigi and Riccipetitoni, Giovanna and Siracusa, Fortunato and Spreafico, Filippo and Tamaro, Paolo and Cecchetto, Giovanni} }