Treatment approaches in ovarian masses in children

Year 2021, Volume: 9 Issue: 2, 73 - 77, 31.08.2021

Kübra Ertan , Mehmet Sarıkaya , Hilal Akbaş Fatma Özcan Sıkı , Buket Kara

https://doi.org/10.21765/pprjournal.877251

Abstract

Aim: The aim of this retrospective study is to evaluate clinical features, treatment approaches and outcomes of children with ovarian mass.
Materials and Methods: In our clinic, the oncologic charts of children with a mass in the ovary between 2009 and 2020 were analyzed retrospectively. The patients' demographic features, symptoms and signs, diagnosis, treatments and outcomes were noticed.
Results: The age of 55 patients included in the study ranged from two months to 18 years (median, 12.9 years). While the ages of 38 patients were ≥ 10 years (69.1%), 17 of them were <10 years (30.9%). Fifty of the patients underwent elective surgery (91%), four had emergency surgery (7.3%), one patient's family refused the treatment (1.8%). Of the surgeries performed, 28 were salpingo-oophorectomy (51.9%), 23 were oophorectomy (42.6%), and 3 were cystectomy (5.6%). The types of ovarian mass were germ cell tumors (n: 44, 80%), epithelial tumors (n: 4, 7.3%), stromal tumors (n: 3, 5.5%), simple cyst (n: 2, 3.6%), and others (n: 2, 3.6%). Two patients with malignant tumor (one dysgerminoma patient with ataxia telangiectasia, and the other with yolk sac tumor) died while the others were alive.
Conclusion: In children, benign tumors are more prominent and surgical treatment is sufficient. In malignant tumors, overall survival rates have increased with multidisciplinary approaches.

Keywords

children, ovary, mass

Supporting Institution

None

Thanks

The authors would like to thank Professor Yavuz Köksal (from Departments of Pediatric Hematology and Oncology, Selcuk University, Konya, Turkey) and Professor İlhan Çiftçi (from Departments of Pediatric Surgery, Selcuk University, Konya, Turkey) for their support.

References

• 1. Kelleher CM, Goldstein AM. Adnexal masses in children and adolescents. Clin Obstet Gynecol. 2015; 58(1):76-92.
• 2. Hermans AJ, Kluivers KB, Wijnen MH, Bulten J, Massuger LF, Coppus SF. Diagnosis and treatment of adnexal masses in children and adolescents. Obstet Gynecol. 2015; 125(3): 611-5.
• 3. Schultz KA, Ness KK, Nagarajan R, Steiner ME. Adnexal masses in infancy and childhood. Clin Obstet Gynecol. 2006; 49(3): 464-79.
• 4. van Winter JT, Simmons PS, Podratz KC. Surgically treated adnexal masses in infancy, childhood, and adolescence. Am J Obstet Gynecol. 1994; 170(6): 1780-6.
• 5. Sonmez K, Turkyilmaz Z, Karabulut R, Can Basaklar A. Ovarian masses in infant-juvenile age. Arch Argent Pediatr. 2018; 116(3): e359-e364.
• 6. Koksal Y, Reisli I, Gunel E, Caliskan U, Bulun A, Kale G. Galactorrhea-associated granulosa cell tumor in a child. Pediatr Hematol Oncol. 2004; 21(2):101-6.
• 7. Savic D, Stankovic ZB, Djukic M, Mikovic Z, Djuricic S. Torsion of malignant ovarian tumors in childhood and adolescence. J Pediatr Endocrinol Metab. 2008; 21(11): 1073-8.
• 8. Pedrazzoli P, Rosti G, Soresini E, Ciani S, Secondino S. Serum tumour markers in germ cell tumours: from diagnosis to cure. Crit Rev Oncol Hematol. 2021: 103224.
• 9. Rathore R, Sharma S, Arora D. Spectrum of childhood and adolescent ovarian tumors in India: 25 years experience at a single institution. Open Access Maced J Med Sci. 2016; 4(4): 551-5.
• 10. Morowitz M, Huff D, von Allmen D. Epithelial ovarian tumors in children: a retrospective analysis. J Pediatr Surg. 2003; 38(3):331-5.
• 11. Akyuz C, Varan A, Buyukpamukcu N, Kutluk T, Buyukpamukcu M. Malignant ovarian tumors in children: 22 years of experience at a single institution. J Pediatr Hematol Oncol. 2000; 22(5): 422-7.
• 12. Young RH, Kozakewich HP, Scully RE. Metastatic ovarian tumors in children: a report of 14 cases and review of the literature. Int J Gynecol Pathol. 1993; 12(1):8-19.
• 13. Patte C, Auperin A, Michon J, et al. Société Française d'Oncologie Pédiatrique. The Société Française d'Oncologie Pédiatrique LMB89 protocol: highly effective multiagent chemotherapy tailored to the tumor burden and initial response in 561 unselected children with B-cell lymphomas and L3 leukemia. Blood. 2001; 97(11):3370-9.
• 14. Singla V, Prabhakar N, Khandelwal N, et al. Role of perfusion CT in the evaluation of adnexal masses. J Obstet Gynaecol. 2019; 39(2): 218-23.
• 15. Ishiguro T, Yoshida Y, Tenzaki T, Ohshima M, Suzuki H. AFP in yolk sac tumor and solid teratoma of the ovary: significance of postoperative serum AFP. Cancer. 1981; 48(11): 2480-4.
• 16. Piippo S, Mustaniemi L, Lenko H, Aine R, Mäenpää J. Surgery for ovarian masses during childhood and adolescence: a report of 79 cases. J Pediatr Adolesc Gynecol. 1999; 12(4): 223-7.
• 17. How JA, Marino JL, Grover SR, et al. Surgically managed ovarian masses at the Royal Children's Hospital, Melbourne -19-year experience. J Pediatr Surg. 2019; 54(9):1913-20.
• 18. Schultz KA, Sencer SF, Messinger Y, Neglia JP, Steiner ME. Pediatric ovarian tumors: a review of 67 cases. Pediatr Blood Cancer. 2005; 44(2):167-73.
• 19. Koksal Y, Caliskan U, Ucar C, et al. Dysgerminoma in a child with ataxia-telangiectasia. Pediatr Hematol Oncol. 2007; 24(6):431-6.