Management of ovarian cysts in neonates, children, and adolescents

The detection of ovarian cysts in the neonate, child, and adolescent has markedly increased with the widespread use of ultrasonography. The previous dogma that any ovarian lesion detected before puberty mandates surgical exploration is no longer valid. Observation of the asymptomatic and mildly symptomatic cyst is now required before proceeding to surgery. The physiology of the ovary from intrauterine development through puberty is discussed. Current literature is reviewed to provide a rationale to the proposed treatment protocols of ovarian cysts in utero, in childhood, and in adolescence.