abstract
OBJECTIVE:
To
investigate the incidence, age of onset and tumor marker levels in
benign and malignant pediatric ovarian neoplastic tumors. Design.
Retrospective database study.
SETTING:
Single center study.
POPULATION:
Forty-five 0-15 year old patients operated on for ovarian neoplastic tumors from the beginning of 1999 to the end of 2013.
METHODS:
Serum
alpha-fetoprotein, human chorionic gonadotropin and cancer antigen-125
levels as well as follow-up data were recorded from patient charts and
tumor histology was re-evaluated.
MAIN OUTCOME MEASURES:
Incidence
of ovarian neoplastic tumors in the pediatric population. Differences
in patient characteristics and tumor marker levels between those with
benign and malignant tumors.
RESULTS:
The
annual incidence of ovarian tumors was 2.2/100 000 females. Median age
at presentation was 13.0 years (range 0.9-15.7), similar in both the 33
(73%) with a benign and the 12 patients (27%) with a malignant tumor.
The tumors with the highest propensity to metastase (yolk sac tumors,
mixed germ cell tumors, small cell carcinoma) were only found in girls
>9 years. Elevated serum alpha-fetoprotein and cancer antigen-125
values associated more often with malignant tumors (p<0.001 and
0.031, respectively). There were no deaths or local recurrences. Four
patients with a mature teratoma developed a contralateral benign ovarian
tumor during follow-up.
CONCLUSIONS:
Both
benign and malignant ovarian tumors are rare in the pediatric
population, but the incidence increases with age. High alpha-fetoprotein
and cancer antigen-125 levels were associated with malignant tumors.
The prognosis of the pediatric ovarian tumors seems to be favorable.
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