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Ovarian tumors in children
1Department of Surgery, University of Louisville School of Medicine, KY 40292.
Southern Medical Journal
|April 1, 1988
Summary
Pediatric ovarian tumors, though rare, can be malignant. Germ cell tumors are most common. Treatment involves surgery and chemotherapy, prioritizing ovarian tissue preservation in benign cases.
Area of Science:
- Pediatric Oncology
- Gynecologic Oncology
- Surgical Pathology
Background:
- Ovarian tumors in children are rare but can be life-threatening, with germ cell tumors being the most frequent type.
- Malignant ovarian neoplasms require aggressive treatment including surgery and multi-drug chemotherapy to enhance survival rates.
- Preservation of ovarian tissue is a critical consideration for pediatric patients diagnosed with benign ovarian tumors.
Purpose of the Study:
- To review the management and outcomes of pediatric ovarian tumors treated over a 19-year period.
- To analyze the types of ovarian tumors, presenting symptoms, diagnostic methods, and treatment strategies.
- To evaluate survival rates and identify factors influencing patient outcomes.
Main Methods:
- Retrospective review of 30 pediatric patients with ovarian tumors treated at Kosair Children's Hospital.
- Analysis of presenting symptoms, diagnostic imaging (X-ray, ultrasonography, IVP), and surgical interventions.
- Evaluation of pathological findings, treatment protocols (surgery, chemotherapy), and patient survival data.
Main Results:
- The average patient age was 12 years, with common symptoms including acute/chronic pain, increased abdominal girth, and palpable mass.
- Of 30 tumors, 22 were benign and 8 were malignant. Malignant tumors included 6 germ cell tumors, 1 sex cord tumor, and 1 cystadenocarcinoma.
- Benign tumors were treated with cystectomy/oophorectomy; malignant tumors underwent oophorectomy/salpingo-oophorectomy followed by chemotherapy and "second look" procedures, with survival ranging from 5 months to 9 years (average 46 months).
Conclusions:
- Ovarian tumors in children necessitate prompt diagnosis and appropriate management, balancing oncologic outcomes with tissue preservation.
- Germ cell tumors are the predominant malignant type in this age group, requiring multimodal therapy.
- While challenging, effective treatment strategies can lead to long-term survival for pediatric patients with ovarian malignancies.