Paediatric Ovarian Tumours: Appropriate Investigations and Management
Paediatric Ovarian Tumours: Appropriate Investigations and Management
Irina Earnshaw*, James Fraser Horwood**, Edmund Cheesman***, Ross Craigie****
University of Manchester, Manchester, UK*, Royal Manchester Children’s Hospital, Manchester, UK**, Royal Manchester Children’s Hospital, Manchester, UK***, Royal Manchester Children’s Hospital, Manchester, UK****
The rarity of paediatric ovarian tumours and their incomparability with adult ovarian tumours has made their management an area of uncertainty for many years. Most of these tumours are benign, and have a risk of metachranous disease, so preservation of the affected ovary is preferable. We sought to find under what circumstances this was possible, and how surgeons can guide their decision-making.
Patients & Methods
A pathology database search returned 59 reports of 60 tumours, occurring in 49 patients.
Twenty-five tumours were left-sided, 26 right-sided, 3 bilateral and 3 extra-ovarian metastases. Mean age at presentation was 12.6 ± 3.7 years. Thirty-six (60%) were benign, 3 (5%) were borderline and 20 (33.3%) were malignant, and the majority (78%) were germ cell tumours. Twenty-four percent of ovaries were preserved. The current mean follow-up period is 22 ± 24.5 months, with 18 patients discharged so far. Metachranous disease occurred in 6.1% of patients, and ipsilateral recurrence occurring in 13.3% of preserved ovaries. Two patients have reported reproductive issues.
A number of patients underwent oophorectomy when preservation of the ovary may have been possible. It is recommended that preservation should be attempted in all cases where the tumour is under 10cm and tumour markers are negative. If the tumour markers are negative and the tumour is over 10cm, approach is at the discretion of the surgeon, but preservation of the ovary should be the main goal, with the understanding that a second look operation may be necessary if histology returns a malignancy.
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Earnshaw I, Horwood F J, Cheesman E, Craigie R.. Available From : Conference_abstracts/report.aspx?reportid=850
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