[Treatment strategy in malignant genital tumors in childhood and adolescence]

In the period of 1960-1987 at the Clinic for Gynecology and Obstetrics in Novi Sad 30,398 extensive abdominal and vaginal operations were carried out. In the same lapse of time 59 female patients in their childhood or adolescence were operated on due to an ovarian gland tumor. There were 5 female patients up to the age of 14, and 54 female patients from 14-18 years of age. There were 4 malignant tumors: 2 in childhood age, and 2 in adolescence, and 55 benign ones. By presenting the severeness of the diagnosis (the rarity of the tumor) and the complete treatment strategy, the authors state the principals which should be observed with operations on the genitals of children and adolescents: operation is the method of choice; these cases should be operated on in great medical centers; "ex tempore" biopsy is necessary. The extent of the operative procedure presents a delicate problem, because great care should be taken about the endocrine function of the ovary, the somatic development, menstrual and reproductive function, potential malignancy, and possible relapse, so the authors speak in favor of relaparotomy and radicalization of the first procedure rather than in favor of a great radicalization in the first act. Depending on the nature of the tumor, postoperative irradiation or chemotherapy is recommended. In prevention, regarding early diagnosis, the opening of school dispensaries for childhood and adolescent gynecology is recommended, as well as vaginoscopic examination and the interdisciplinary work of the gynecologist, the surgeon for children and the pediatrician.