A clinicopathological study on ovarian tumors of children under the age of 15 years was made on series of 23 patients operated on at the department of pediatric surgery, Hanyang University, Seoul Korea from January, 1978 to July, 1993.
The treatment for ovarian tumors in generally the same as with adults, but special consideration should be taken to consider the nomal physiology and maintenance of fetility as well as the possibility of growth. Adjuvant chemotherapy and
radiotherapy
have recently been undertaken according to the type, size, stage, and grade after surgery of a malignant tumor, but be cause the normal physiology and the possibility of growth must be taken into account in children, special emphasis must be
made.
@ES The results were as follows:
@EN 1) The incidence of non-neoplastic tumors was 16.5%(4) of which follicular cyst and lutein cyst comprised 4.2%(1), 12.3%(3) respectively. And neoplastic tumors represented 83.5%(20) of all ovarian tumors of which germ cell tumor, epithelial
tumor,
sex cord-stromal tumor and metastatic tumor comprised 58.3%(14), 8.4%(2), 8.4%(2) and 8.4%(2) respectively.
2) Benign tumors represented 58%(14) and malignant ones 42%(10). In the case of malignant tumors, the incidences of the immature teratoma. endodermal sinus tumor. dysgerminoma, mucinous cystadenoma of borderline malignancy, Leydig cell tumor,
juvenile
granulosa cell carcinoma, and metastatic tumor were 8.4%(2), 4.2%(1), 8.4(2), 4.2%(1), 4.2%(1), 4.2%(1) and 8.4%(2)
3) The mean ages of non-neoplastic tumors, germ cell tumors, epithelial tumors, sex cord-stromal tumors and metastatic tumors were 3.8 years. 9.7 years, 12 years, 8.5 years and 12.5 years respectively and the overall mean age of all ovarian
tumors
was
9.0 years.
4) As for the subjective complaints in ovarian tumors, abdominal pain was noted in 42%(10) of the cases, abdominal mass in 46%(11), abdominal distention in 29%(7), nausea and vomiting in 17%(4) and sings of precocious puberty such as uterine
bleeding
in 4.2%(1) and breast enlargement in 8.4%(2). Interestingly uterine bleeding and breast enlargement were observed in a 36 months-old with follicular cyst and breast enlargement was observed in a 38 months-old with Leydig cell tumor. And as for
the
duration of abdominal pain, acute onset was noted in 4 cases, subacute in 2 cases and chronic in 4 cases.
5) As for the objective findings, a palpable abdominal mass was observed in 71%(17) of the cases, abdominal tenderness in 42%(10), abdominal distention in 29%(7) and breast enlargement in 8.4%(2).
6) As for the blood types in 9 cases, 0 type was noted in 4 cases, A type in 3 cases and B type in 2 case.
7) Sixty-one percent914) was noted in left ovary, 26%(6) in the right and 13%(3) biliaterally. Of the three bilateral cases, there was one of a right maute teratoma combined with a left lutein cyst, a case of a bilateral mature teratoma and a
bilateral
Krukenberg tumor.
8) The mean sizes of non-neoplastic tumors, germ cell tumors, epithelial tumors, sex-cord stromal tumors and metastatic tumors were 6cm, 10.9cm, 21.5cm, 17.3cm and 5.7cm. And the overall mean size of the ovarian tumors was 11.1cm.
9) As for the complication of the ovarian tumors, torsion was noted in 20.8%(5) and rupture in 4.2%(1). The degree of torsion was 360°in four cases and 720° in one case.
10) As for the operative management, the unilateral salpingo-oophorectomy was performed in 60%(15), unilateral oophorectomy in 24%(6), bilateral oophorectomy in 4%(1), ovarian cystectomy in 4%(1), cyst wedge resection in 4%(1) and enucleation in
4%(1)
respectively
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