Ovarian neoplasia in adolescence: a retrospective chart review of girls with neoplastic ovarian tumors in Saudi Arabia

Abstract

Background Ovarian neoplasia in children and adolescents is a rare tumor. The diagnosis and management of such tumors is often difficult and delayed due to non-specific symptoms and low suspicion. Surgical management that preserves fertility and ovarian function should be the goal. Objective This study aimed to review the clinical presentation, tumor characteristics, and management of Saudi Arabian adolescents. Methods A retrospective chart review was conducted on adolescent girls aged 19 or less admitted to tow referral hospital in Riyadh, Saudi Arabia, diagnosed with adnexal mass over an 8 years’ period; patients who were older than 19 were excluded. The data collected from patients’ charts included age, presenting symptoms, radiologic findings, type of surgery, specialist who performed the surgery, and histopathology of the tumors. We classified patients according to age using the three WHO developmental stages: early adolescence (10–13 years old), middle adolescence (14–16 years old), and late adolescence (16–17 years old). The statistical study used SPSS version 18.0 to determine the data’s frequency, distributions, and means (SPSS Inc., Chicago, IL). Results We analyzed 164 patients, between 10 and 19 years old, admitted to two hospitals between 2009 and 2017. We found that 85% of these patients underwent surgery for adnexal mass removal, and 90.2% were symptomatic or emergency cases. The majority of our patients were post-menarche (96.95%), and were between the ages of 14 and 19. The most common surgical procedure for tumor removal was laparoscopic cystectomy (74.4%). An adnexal mass with a solid component on ultrasound is the most commonly found indicator of malignancy. The majority of tumors were benign (32.3%). Germ cell tumors were the most common (68.7%) malignant tumor, and yolk sac tumors were the most common subgroup of germ cell tumors. When managed by a gynecologist, surgical intervention can be a successful method of preserving fertility. Conclusions Our results confirm that the majority of neoplastic ovarian tumors in children and adolescents are benign, and surgical intervention can be used to maintain fertility, especially when managed by a gynecologist. This is one of the largest reported series and the first from our area.

Overview on Screening and Prevalence of Ovarian Neoplasms in Saudi Arabia

“…Malignant ovarian neoplasms are more common as people get older [1]. Another study in Riyadh indicated that most neoplastic ovarian tumors in children and adolescents are benign [2]. The third Study indicated that Ovarian tumor incidence was 4.1% national wide [16].…”

“…Neoplastic ovarian tumors in children and adolescents are rare, accounting for 0.9 to 2% of all tumor types in this age group. Furthermore, according to certain research, this age group has roughly 2.6 cases per 100,000 females each year [2][3][4][5][6][7][8][9][10][11].…”

Current State of the Reproductive Health of Adolescent Girls and the Issues of Abnormal Uterine Bleeding as Its Component (Literature Review)

“…In the adolescent population, malignant gynecologic neoplasms are rare -17 cases per 100,000 people [17] or 4.2-5% of all malignant pathology in girls aged 0-18 years [18]. The tumours primarily affect the ovaries, as well as the uterus, cervix, vagina, and vulva [19]. It is known that treatment of malignant tumours of the reproductive system in adolescents can affect fertility and sexual function due to the adverse reproductive effects of surgery, chemotherapy, and radiation therapy [20].…”

“…У підлітковій популяції нечасто трапляються злоякісні гінекологічні новоутворення -17 випадків на 100000 осіб [17] або 4,2-5% від усієї злоякісної патології дівчат віком 0-18 років [18]. Новоутворення насамперед вражають яєчники, а також матку, шийку матки, піхву та вульву [19]. Відомо, що лікування у підлітків злоякісних пухлин репродуктивної системи може позначитися на фертильності, сексуальній функції внаслідок несприятливих репродуктивних ефектів хірургічного лікування, хіміо -та променевої терапії [20].…”

Therapeutic Management and Prognostic Factors for Ovarian Malignant Tumours in Adolescents: A Comprehensive Review of Current Guidelines

“…Moreover, the therapeutic management of ovarian tumours is rather demanding, requiring expertise and precise design, tailored to the specific needs of non-adult patients [ 21 ]. Suggested treatment should simultaneously be curative and oncologically safe, ovarian function and fertility-sparing if possible, minimally invasive and sensitive to the psycho–emotional impact on this vulnerable population [ 1 , 22 , 23 ]. The rarity of ovarian cancer in adolescents further complicates the management of the disease, since the majority of information available to clinicians handling such cases can mostly be obtained by case reports and case series, while only a small number of official guidelines relevant to this topic have been issued.…”