ADOLESCENT OVARIAN TUMORS: A CLINICOPATHLOGICAL REVIEW OF 15 CASES
AbstractBackground: 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 HospitalRawalpindi during the period of enrolment. Out of 15 cases 12 were managed surgically. Data wasrecorded 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 upfor one year. Results: Majority of patients fell in the subgroup 14–16 year age. Majority harboringovarian malignancy belonged to subgroup 17–19 years. Clinical presentation in the majority was massabdomen 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 wasbenign in 11 cases and malignant in 4. In 3 cases cyst fluid was negative for malignancy. In 2 cyst wallbiopsy and one patient where entire cyst was removed histopathology revealed benign serous cystadenoma/luteal cyst (26%). There were 5 cases of dermoid cysts (33.3%) , one patient had bilateraldermoids, one malignant and one benign. All 4 malignancies were found to be to non-epithelial onhistopathology. One case had surgery twice. Unilateral oopherectomy followed by recurrence and totalabdominal hysterectomy and contralateral salpingo-oopherectomy after 2 years. Conclusion: Thisstudy shows the preponderance of non-epithelial tumours and high percentages of malignant germ celltumours 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 markersSurgery should as much as is safely possible be fertility preserving.Key words: Ovarian tumours, Adolescent, Fertility preservation
Goldstein DP, Laufer MR. Benign and malignant ovarian masses.
In: Emails SJ, Laufer MR, Goldstein DP, editors. Pediatric and
adolescent gynecology. Philadelphia: Lippincott-Raven; 1998.
Warner BW, Kuhn JC, Barr LL. Conservative management of
large ovarian cysts in children: the value of serial pelvic
ultrasonography. Surgery 1992;112:749–55.
Cass DL, Hawkins E, Brandt ML, Chintagumpala M, Bloss RS,
Milewicz AL, et al. Surgery for ovarian masses in infants,
children, and adolescents: 102 consecutive patients treated in a 15-
year period. J Pediatr Surg 2001;36:693–9.
Breen JL, Maxson WS. Ovarian tumours in children and
adolescents. Clin Obstet Gynecol 1977;20:607–23.
Schultz KA, Sencer SF, Messinger Y, Neglia JP, Steiner ME.
Pediatric ovarian tumors: A review of 67 cases. Pediatr Blood
You W, Dainty LA, Rose GS, You W, Dainty LA, Rose GS, et
al. Gynecologic malignancies in women aged less than 25 years.
Obstet Gynecol 2005;105:1405–9.
Pilli GS, Suneeta KP, Dhaded AV, Yenni VV. Ovarian tumours: a
study of 282 cases. J Indian Med Assoc 2002;100:420,423–4, 447.
Pfeifer SM, Gosman GG. Evaluation of adnexalmasses in
adolescents. Pediatr Clin North Am 1999;46:573–92..
Huffman JW. The Gynaecolgy of children andadolescents.
Philadelphia: Sanders; 1968.
Sah SP, Uprety D, Rani S. Germ cell tumors of the ovary:
aclinicopathologic study of 121 cases from Nepal. J
ObstetGynaecol Res 2004;30:303–8.
Ahmad Z, Kayani N, Hasan SH, Muzaffar S, Gill MS.
Histological pattern of ovarian neoplasm. J Pak Med Assoc
Hassan E, Creatsas G, Deligeorolgou E, Michalas S. Ovarian
tumors during childhood and adolescence. A clinicopathological
study. EurJ Gynaecol Oncol 1999;20:124–6.
Lipitz, S, Seidman, DS, Menczer, J, Bider D, Oelsner G,
Moran O, et al. Recurrence rate after fluid aspiration from
sonographically benign-appearing ovarian cysts. J Reprod
Pansky, M, Abargil, A, Dreazen, E, Golan A, Bukovsky I,
Herman A. Conservative management of adnexal torsion in
premenarchal girls. J Am Assoc Gynecol Laparosc 2000;7:121–4.
Goldstein DP, deCholnoky C, Emans SJ, Leventhal JM.
Laparoscopy in the diagnosis and management of pelvic pain in
adolescents. J Reprod Med 1980;24:251–6.
Aziz D, Davis V, Allen L, Langer JC. Ovarian torsion in children:
Is oophorectomy necessary? J Pediatr Surg 2004;39:750–3.