Epithelial ovarian neoplasms are rare in patients under the age of 20 years.
Few series have found any premenarchal adolescents with these lesions.

Serous cystadenomas are the most common. They are often unilocular, with a thin wall and a clear content, and they rapidly increase in volume. They are rarely bilateral and their rate of malignancy ranges from 7.5 to 30%.

Mucinous cystadenomas are multilocular with a thick content and a wall of variable, irregular thickness. They tend to recur and regular surveillance is necessary over a period of several years. In a series of 19 patients with epithelial ovarian neoplasms and aged under 21 years (range 14 - 21), 9 serous tumors, 7 mucinous tumors, 2small cell carcinomas and 1 endometrioid carcinoma were found. Most (84%) were low malignant potential or well-differentiated tumors.

Surgical treatment consisted of unilateral salpingo-oophorectomy in 12patients, total hysterectomy and salpingo-oophorectomy in 6 patients and cystectomy in 1 patient. Fifteen patients had FIGO stage 1 disease and survival was good with preservation of fertility. Four patients had stage III disease at the time of diagnosis. Two deaths occurred in this series, both in patients with small cell anaplasia.