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Pelvic masses in young girls

Pelvic masses are uncommon in girls before puberty. Occasionally they are found by accident when the girl has symptoms like tummy pain which are unrelated. 

An ultrasound examination is usually one of the first investigations requested because it is non-invasive. We put the ultrasound transducer on the lower abdomen and if the bladder is reasonably full then good images of the bladder, uterus, vagina and ovaries are easily achieved.

There are many different causes of a pelvic mass but ultrasound examination can distinguish which organ it arises from and what the likely pathology is.

Ovarian causes include

  • Dermoid cysts which are developmental and always benign
  • Follicular cysts from the developing ovary

Uterine causes include

  • Haematometra or haematocolpos where menstrual blood has distended the uterus and or vagina because there is a blockage to flow
Renal (kidney) causes include
  • A pelvic kidney, where the kidney is located in the pelvis instead of its usual position higher in the abdomen

Infections and cancer are very rare in this age-group.

A dermoid cyst on the left ovary of a young girl