Malignant and borderline epithelial ovarian tumors in the pediatric and adolescent population

Malignant and borderline ovarian tumors of epithelial origin are rarely encountered among prepubertal girls and adolescents. The aim of this population-based study was to elucidate their clinicopathological characteristics and prognosis using a multi-institutional tumor registry.

The National Cancer Institute's Surveillance, Epidemiology, and End Results database was accessed and a cohort of females aged <=19years old, diagnosed between 1988 and 2013 with a borderline ovarian tumor (BOT) or a malignant epithelial ovarian carcinoma (EOC) was accessed. Observed survival (OS) was assessed using the Kaplan-Meier method. Comparisons were made using the log-rank test.

A total of 114 cases diagnosed with BOT between 1988 and 2000 were identified; 61/114 (53.5%) and 51/114 (44.8%) of BOT were of serous or mucinous histology respectively. Ten-year OS for those with BOT was 97.3%. A total of 140 cases of EOC were identified. Median age was 17 years and the most common histological subtypes were mucinous 79/140 (56.4%) and serous 29/140 (20.7%) adenocarcinoma. Most had stage I disease 92/131 (70.2%) and fertility-sparing surgery was commonly performed. Five-year OS for those with stage I disease was 93.6% compared to 48.3% for cases with exta-ovarian tumor spread (p<0.001).

BOT and EOC are exceedingly rare in the pediatric and adolescent population. In this age group EOC consists mostly of low-grade mucinous and serous tumors confined to the ovary. OS survival for those with stage I disease is excellent.