Ovarian tumors in the pediatric age group: 37 cases treated over an 8-year period

Background: Ovarian tumors have generally been considered rare in the pediatric age group. We reported our experience dealing with pediatric ovarian tumors during an 8-year period. Methods: Between January 1998 and December 2006, 37 girls with ovarian tumors were treated at the Department of Pediatric Surgery, Chang Gung Children's Medical Center. Modes of clinical presentation, pathology diagnosis, methTWNods of treatment and clinical outcome were retrospectively analyzed. Results: Twenty-nine of the 37 patients were symptomatic with abdominal pain, abdominal distention or the presence of a palpable mass, reduction in appetite or nausea and vomiting and precocious puberty. Another 8 patients were diagnosed prenatally. Thirty patients had benign disease and 7 had malignant tumors. The malignant lesions included 5 germ cell tumors (2 yolk sac tumors, 2 immature teratomas, 1 dysgerminoma), and 2 sex cord stromal tumors. Operations performed were salpingo-oophorectomy (n = 22), oophorectomy (n = 8), cystectomy (n = 3), aspiration (n = 2) and biopsy only (n = 2). A laparoscopic approach was performed in 10 cases. Patients with stage II yolk sac tumors (n = 2) or grade III immature teratomas (n = 2) had elevated alpha-fetoprotein levels, and the patient with dysgerminoma was diagnosed as stage II b. All underwent salpingo-oophorectomy and received chemotherapy following their initial operation and remained free of disease at 8 months to 6 years of follow-up. Conclusions:In our studies, most ovarian tumors were benign. Epithelial cysts and teratomas were the most common benign lesions, and germ cell tumors were the most common malignancy. A laparoscopic approach was feasible in most cases. With accurate staging, complete resection, and chemotherapy for malignant tumors, patients are expected to have excellent survival rates.