Diagnosis, pathology, staging, treatment, and outcome of epithelial ovarian neoplasia in patients age < 21 years

Abstract

BACKGROUND Epithelial ovarian neoplasms are rare in patients under the age of 21 years. This is a report of a series of such patients documenting their presentation, histologic type, stage of disease, treatment, and outcome. METHODS Clinical findings, histology, stage, treatment, and outcomes of 19 patients with epithelial ovarian neoplasia are reported. All histology was rereviewed. RESULTS The median age at the time of diagnosis was 19.7 years (range, 14.1–21.8 years), and the median follow‐up was 5.6 years (range, 0.2–19.5 years). The most common presenting symptom was dysmenorrhea (100%) followed by abdominal pain (68%), and the initial diagnosis usually was made ultrasonographically. There were nine (47%) serous tumors, 7 (37%) mucinous tumors, 2 (11%) small cell carcinomas, and 1 (5%) endometrioid carcinoma. Seventy‐nine percent of tumors were unilateral, and 84% were low malignant potential or well differentiated tumors. Surgical treatment included unilateral salpingo‐oophorectomy in 12 patients (63%), total abdominal hysterectomy and bilateral salpingo‐oophorectomy in 6 patients (32%), and ovarian cystectomy in 1 patient (5%). Fifteen patients (79%) had Stage I disease, and 4 patients (21%) had Stage III disease at the time of diagnosis. There were two deaths in this series, and both occurred in patients with small cell anaplastic carcinoma. CONCLUSIONS Epithelial ovarian neoplasias are rare in patients in this age group but must be included in the differential diagnosis of an ovarian mass. Most patients present with Stage I tumors of low malignant potential. In these patients, good survival is achieved with unilateral salpingo‐oophorectomy and preservation of fertility. In contrast, small cell carcinomas are very aggressive, and patients with this variant require intensive therapy. Cancer 2001;91:2065–70. © 2001 American Cancer Society.

Epithelial Ovarian Tumors in Adolescents: A Retrospective Pathologic Study and a Critical Review of the Literature

“…Notably, few series have found any premenarchal girls with epithelial ovarian neoplasia, 18 and it has been previously suggested that the development of epithelial ovarian tumors may be triggered by hormonal stimulation. 11 In our present study, only a single case of a premenarchal girl presenting with a mucinous cystadenoma was identified. The slightly higher frequency (26.7%) of epithelial ovarian neoplasms observed in our series in comparison to almost all previous reports could be because of the inclusion of only adolescent cases (10-19 years old, as defined by WHO) in our study sample, and to the significantly higher mean and median age of our patients.…”

Tumores ováricos en niñas y adolescentes

“…La torsión fue superior en el grupo de lesión ovárica funcional (n= 15; 71,4%), seguido del grupo de tumores germinales (n= 5; 23,8%) y de lesiones epiteliales (n= 1; 4,8%) (p= 0,004, p= 0,001, respectivamente). Se halló que la torsión fue estadísticamente significativa en 13 Distribución de las 56 lesiones ováricas, edad (mediana, media ± DE, años), duración (media ± DE, días), tamaño (media ± DE, cm), estudios de RMN/TC, análisis de marcadores tumorales, situación en relación con la menarquia, torsión -/+, tumor -/+, dolor -/+, vómitos -/+, irregularidades menstruales -/+, otros síntomas -/+ (quiste intrauterino, aumento de peso, pubertad precoz), ubicación (derecha/izquierda/bilateral), tipo de cirugía y cirugía de urgencia en todos los grupos. @, €, ∑, ≠= p < 0,05; M= malignidad.…”

“…La neoplasia epitelial en las niñas es muy poco frecuente, pero sigue siendo parte del diagnóstico diferencial de cualquier tumor ovárico. 13 Deprest y col., informaron que el 19,3% de todos los tumores ováricos tenían origen epitelial y que la mayoría de estos -15,9% de los tumores de todas las pacientes de las 10 serieseran malignos.…”

Ovarian masses in infant-juvenile age

“…Epithelial neoplasia in chidren is very rare but remains part of the differential diagnosis of any ovarian mass. 13 Deprest et al reported that 19.3% of all ovarian tumours were epithelial in origin, and in the majority of these-15.9% of tumours in all patients from the 10 series-were malignant.…”