Solid ovarian tumours in childhood: a 35-year review in a single institution

Abstract

Purpose: Solid ovarian tumours are uncommon in childhood. Our aim is to evaluate the outcomes in a single institution over 35 years.

Methods: We reviewed their clinical presentation, management, pathology and outcomes from 1972 to 2007.

Results: Fifty-three patients, with a median age of 9.2 years (range 0.9-14.2), were registered. Common symptoms at presentation were abdominal pain (75.8%) and abdominal mass (57.4%). Histopathological diagnoses were: 26 mature teratoma, 10 immature teratoma, 8 dysgerminoma, 5 granulosa cell tumours, 2 yolk sac tumours, 1 gonadoblastoma and 1 embryonal carcinoma. Staging (FIGO) for malignant/borderline tumours was: 17 stage I, 1 stage II, 8 stage III and 1 stage IV. Unilateral salpingo-oophorectomy was performed in 47 cases. Sixteen patients underwent chemotherapy after surgery (15 with platinum-based regimen) and postoperative radiotherapy was given in 5 cases. Recurrence was observed in 2 patients and one died (stage III immature teratoma) after a second relapse despite multiple chemotherapy, surgery and radiotherapy. Five-year OS and 5-year EFS were 97% and 94% respectively.

Conclusions: Although rare, ovarian tumours must be included in the differential diagnosis of abdominal pain in childhood. Our results confirm their excellent prognosis using conservative surgery and platinum-based chemotherapy. The key point is to maintain excellent outcome while reducing associated morbidity and preserving fertility.