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

Background: Pediatric ovarian tumors are rare. The aim of this work is to study the epidemiological characteristics and treatment outcome of these tumors in our locality.

Methods: This retrospective study was performed in accordance with the ethical policies. Between January 2011 to December 2015, Thirteen cases of pediatric ovarian cancers were recorded in the Pediatric Oncology Unit of Oncology Center of Mansoura University and the Clinical Oncology & Nuclear Medicine Department of Mansoura University Hospital. The clinico-epidemiologic data and the treatment protocols were analyzed.

Results: The median age was 10 years (range: 2-17). Presenting symptoms were mainly lower abdominal pain (6; 46.2%) and palpable abdominal mass (4; 30.7). Through laparotomy all patients underwent unilateral salpingo-oophorectomy except one case for whom bilateral salpingio-oophorectomy was done. Six patients were stage I (46.2%), 2 patients were stage II (15.4%) and 5 patients were stage III tumors (38.4%). The majority had germ cell tumors (11; 85%). Adjuvant chemotherapy was given to all cases. Further chemotherapy was needed in 6 cases due to progression or recurrence. The median follow up was 35 months while the median overall survival was 40 months. Mortality rates were 90% in stages II and III together. The advanced stages and yolk sac pathology had the highest mortality. One of the survived cases got married and delivered a baby.

Conclusion: Germ cell tumors are the commonest pediatric malignant ovarian tumors. Multimodality treatment is essential. Fertility preservation should be respected. Our mortality rates are relatively high.