ADOLESCENT OVARIAN TUMORS: A CLINICOPATHLOGICAL REVIEW OF 15 CASES
Abstract
Background: To prospectively review the clinicopathologic pattern and out come in 15 patients withadolescent ovarian tumours in Military Hospital Rawalpindi between Jan 2004 to Sep 2007. Methods:
All cases of adolescent ovarian tumours reporting to the gynaecology department of Military Hospital
Rawalpindi during the period of enrolment. Out of 15 cases 12 were managed surgically. Data was
recorded regarding clinical presentation, patient's age, size of tumour, bilaterality, histopathology,
staging if tumour was malignant and sites of extra ovarian involvement. All patients were followed up
for one year. Results: Majority of patients fell in the subgroup 14-16 year age. Majority harboring
ovarian malignancy belonged to subgroup 17-19 years. Clinical presentation in the majority was mass
abdomen and abdominal distension. Approach was transcutaneous in 3 (20%), laparoscopic in 2(20%),
and open laparotomy in 10 (60%). Frozen section was performed in 3 cases. Histopathology was
benign in 11 cases and malignant in 4. In 3 cases cyst fluid was negative for malignancy. In 2 cyst wall
biopsy and one patient where entire cyst was removed histopathology revealed benign serous cyst
adenoma/luteal cyst (26%). There were 5 cases of dermoid cysts (33.3%) , one patient had bilateral
dermoids, one malignant and one benign. All 4 malignancies were found to be to non-epithelial on
histopathology. One case had surgery twice. Unilateral oopherectomy followed by recurrence and total
abdominal hysterectomy and contralateral salpingo-oopherectomy after 2 years. Conclusion: This
study shows the preponderance of non-epithelial tumours and high percentages of malignant germ cell
tumours in adolescents. The incidence of malignant tumours in adolescents is higher than in adults.
Early correct diagnosis could be reached by careful physical examination, imaging and tumour markers
Surgery should as much as is safely possible be fertility preserving.
Key words: Ovarian tumours, Adolescent, Fertility preservation
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