[Treatment of childhood genital malignancies]

To present the clinical profile and the result of treatment in childhood genital malignancies.

Twenty seven childhood patients (< 12 years) with genital malignancies diagnosed and treated in Peking Union Medical College hospital were analyzed retrospectively focusing on the clinical characteristics and outcome of the treatment.

Patients ranged in age from 2 to 12 years with mean 6.5 years at diagnosis. Of the 27 patients, 23 had ovarian malignancies including 21 (77.8%) germ cell tumor. Four of the patients had extragonadal tumors with 2 endodermal sinus tumor of the vagina, and 2 embryonic rhabdomysarcoma. In ovarian malignancies, abdominal mass and abdominal pain were main clinical features accounting for 77.8% and 74.1% respectively. In vaginal malignancies, vaginal bleeding and polypoid tumor of the vagina were important clinical manifestations. 91.3% (21/23) of the patients underwent only unilateral salpingo-oophorectomy with preservation of contralateral ovary and the uterus. Childhood genital malignancies were very sensitive to the chemotherapy. Postoperative vincristine, actinomycine, cyclophosphamide (VAC) or cisplatine, vincristine, blyomycine (PVB) chemotherapy was individualized according to the tumor site, International Federation of Gynecology and obstetrics stage and histopathology. Survival rate in our series was 71.4% during the follow-up time (mean 47.4 months).

Malignant germ cell tumor of the ovary is the most common tumor in the childhood genital malignancies. Principle of primary surgery is preservation of fertility and chemotherapy is also considered as a very important treatment modality.