Spectrum of Childhood and Adolescent Ovarian Tumors in India: 25 Years Experience at a Single Institution

Abstract

BACKGROUND:Ovarian tumour in children and adolescent girls form an uncommon but important part of gynaecological malignancies. They account for 1% of all the childhood malignancies and 8% of all abdominal tumours in children. Since the ovarian cysts are thought to arise from mature follicles, these tumours were considered to be infrequent in the paediatric population.AIM:The rarity of this condition prompted us to conduct this study and share our experience on the incidence and clinicopathological features of different ovarian tumours in girls up to 20 years of age observed in last 25 years at a single tertiary care hospital.MATERIAL AND METHODS:This was a retrospective study conducted in the Department of Pathology at a tertiary hospital, Delhi. All ovarian tumours up to the age of 20 years in the past 25 years (1990-2014) were included for the purpose of studying the clinicopathological aspects of ovarian tumours in this age group. Descriptive statistics for prevalence and age-wise prevalence was done. Chi-square test, to find an association between the age, laterality and size with malignancy was performed.RESULTS:We received a total of 1102 cases of ovarian tumours over the period of 25 years (1990 to 2014), of which 112 (10%) cases were seen in girls up to 20 years of age. The mean age of the patients was 15.3 ± 4 years. The most common presenting complaint was pain abdomen (46.4 %) There was a statistically significant correlation found between size and malignancy status of tumours in our study (p = 0.00). Of 112 cases of ovarian tumours, 39/112 (34.8%) were malignant and 73/112 (65.2%) were benign. Mature cystic teratoma (27.6%) was the most common type of benign tumour in this age group and immature teratomas were the most common type of malignant ovarian neoplasms.CONCLUSION:Premenarchal girls with ovarian masses may have varied presentations. Abdominal pain is the most common presenting complaint of young adolescent girls with adnexal masses. So the index of suspicion should be kept high and prompt investigations like ultrasound must be performed early to rule out such adnexal masses. Immature Teratoma was the most common malignant and mature cystic teratoma was the most common benign tumour in our study.

Clinicopathological profile of ovarian tumors in the age group 10-20 years

“…In a study of 25 years conducted by department of pathology (1990-2014), Delhi University by Rathore R showed pain abdomen as the most common presenting symptom in adolescent ovarian tumour followed by abdominal distension. 5 We also had similar results. According to a study of incidence of ovarian tumours below 20 years in IMCH, Calicut showed 76% benign tumours, 35% germ cell tumours and 47% epithelial tumours.…”

Pediatric and Adolescent Malignant Ovarian Tumors: Mansoura 5 - Year Experience

“…No epithelial tumors are reported in the present work unlike the study of Rathore, et al [11]. However, Rathore included patients with a wider age range.…”

“…No documented emergent acute abdomen unlike some reports [10,11]. None of our 2 JSCT cases has precocious puberty, however Bhattacharyya et al [2] in India found 2 cases with precocious puberty out of 3 in his series of 151 malignant pediatric ovarian tumor patients.…”

Diagnostic and Treatment of Ovarian Cystic Lesions in Premenarcheal Girls: a 3 Year Study

“…Ovarian lesions in children are histopathologically classified in non-neoplastic or functional cysts, and neoplastic (benign or malignant) [1,2]. Functional cysts, like follicular cysts or corpus luteal cysts, represent the most frequent ovarian lesions, while the most common benign neoplasms are cystic mature teratomas and serous cyst adenomas [3,4]. Only 10% of the ovarian lesions are malignant, with two-third being germ cell tumors [5] and according to Brookfield et al [6], the incidence of malignant ovarian neoplasms in patients under 9 years of age, was 0.102: 100,000 girls per year.…”

“…There are no specific clinical manifestations for an uncomplicated OCL. Even when complicates, usually by torsion or rupture, it can be easily misdiagnosed as other more frequent cause of acute abdomen, such as acute appendicitis [4]. Although quite rare, may occur signs of precocious puberty, due to estrogen production from a functional cyst [10].…”