Aggarwal Anjali, Lucco Kerith L, Lacy Judith, Kives Sari, Gerstle J Ted, Allen Lisa
Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
J Pediatr Surg. 2009 Oct;44(10):2023-7. doi: 10.1016/j.jpedsurg.2009.06.027.
Epithelial ovarian neoplasms are uncommon in pediatric and adolescent patients, accounting for approximately 20% to 30% of ovarian tumors in adolescent females and women younger than 25. Tumors of low malignant potential (LMP) account for a significant proportion of epithelial neoplasms in this patient population. This case series describes 5 adolescent patients, with a mean age of 14.4 +/- 2.4 years, diagnosed with ovarian tumors of LMP at one institution. Between November 2001 and January 2006, 5 patients were diagnosed with ovarian tumors of LMP of 126 patients who had surgery for adnexal masses. All patients underwent initial surgery via laparotomy. Two patients underwent ovarian cystectomy, and 3 had at least a unilateral salpingo-oophorectomy. One patient had stage IIIc disease, whereas the other 4 patients, not all completely staged, had presumed stage I disease. Three patients developed recurrent ovarian masses on follow-up. Two had recurrent LMP tumors (one bilateral) and one was a benign mucinous cystadenoma. This case series of 5 adolescent patients with ovarian tumors of LMP highlights the importance of considering epithelial neoplasms in any pediatric or adolescent patient with a pelvic mass and supports conservative management, with staging and fertility-sparing surgery; however, appropriate follow-up is essential, as evidenced by 3 of 5 patients exhibiting recurrent ovarian masses.
上皮性卵巢肿瘤在儿科和青少年患者中并不常见,约占青春期女性及25岁以下女性卵巢肿瘤的20%至30%。低恶性潜能(LMP)肿瘤在该患者群体的上皮性肿瘤中占相当大的比例。本病例系列描述了5例青少年患者,平均年龄为14.4±2.4岁,在一家机构被诊断为LMP卵巢肿瘤。在2001年11月至2006年1月期间,126例因附件肿块接受手术的患者中有5例被诊断为LMP卵巢肿瘤。所有患者均通过剖腹手术进行了初次手术。2例患者接受了卵巢囊肿切除术,3例至少进行了单侧输卵管卵巢切除术。1例患者为Ⅲc期疾病,而其他4例患者(并非全部完成分期)推测为Ⅰ期疾病。3例患者在随访中出现复发性卵巢肿块。2例为复发性LMP肿瘤(1例双侧),1例为良性黏液性囊腺瘤。这例包含5例青少年LMP卵巢肿瘤患者的病例系列强调了在任何患有盆腔肿块的儿科或青少年患者中考虑上皮性肿瘤的重要性,并支持保守治疗,包括分期和保留生育功能的手术;然而,适当的随访至关重要,5例患者中有3例出现复发性卵巢肿块就证明了这一点。