Ovarian Tumors in Children: An 11-year Review
Keywords:
Ovarian tumors, Children, Epithelial cell tumor, Germ cell tumor, Sex cord and stromal tumor, Cystadenoma, Teratoma, Granulosa-theca cell tumor, Follicular cystAbstract
Background: Ovarian tumors in girls are important part of gynecological oncology. They may produce a wide range of clinical conditions according to nature, size and a time period of presentation.
Objective: To analyze the data of patients with ovarian tumors treated at Queen Sirikit National Institute of Child Health and compare between benign and malignant characteristics.
Materials and Methods: A retrospective study was conducted by reviewing of medical records of the patients with ovarian tumors treated at Queen Sirikit National Institute of Child Health between 2007 and 2017. Patients’ data including demographics, clinical presentations, investigations, type of ovarian tumors, operative procedures and outcomes were collected and analyzed.
Results: Eighty-six patients were surgically treated for ovarian tumors during the study period. Benign and malignant tumors were classified in 74 (86%) and 12 cases (14%) respectively. Differences in clinical presentation, palpable abdominal mass was more frequent in malignant than benign masses (91.7% : 67.9%; p = 0.023). Precocious puberty and abnormal vaginal bleeding were specific presentation in malignant tumor only. Cystic masses were more frequent in benign than malignant tumors (48.6% : 8.3%; p = 0.002) and solid masses were more common in malignant than benign ovarian tumors (33.3% : 1.4%; p = 0.001). Tumor markers including alpha-fetoprotein (AFP), b-human chorionic gonadotrophin (b-hCG) and lactic dehydrogenase (LDH) significantly elevated in malignant GCTs and SCSTs (p < 0.05). Sizes of the tumors were not differentiated benign from malignant ovarian tumors. Almost all of the 84 cases with ovarian tumors were treated by oophorectomy or salpingo-oophorectomy. All 74 benign cases were alive. One case of the malignant group with T-cell lymphoma died one month after surgery and 4 cases lost to follow-up. The 2-year survival rate was 58.3%.
Conclusion: Benign ovarian tumors had more common occurrence 6 times than malignant ones. Presentations of palpable abdominal mass, solid tumor from imaging and elevation of serum tumor markers were strongly suspicious of malignant tumors of the ovary.
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