Rajeswari B, Nair M, Ninan A, Parukuttyamma K
Division of Pediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Indian J Cancer. 2016 Apr-Jun;53(2):292-295. doi: 10.4103/0019-509X.197726.
Ovarian tumors are uncommon in childhood and constitute around 1% of childhood malignancies. Two thirds of pediatric ovarian tumors are germ cell tumors. Epithelial ovarian tumors and stromal tumors are less frequent. We share our experience in childhood ovarian cancers, analyzing a series of cases with respect to the clinical profile, treatment and survival.
All newly diagnosed ovarian tumors in children up to 14 years of age, registered in our Pediatric Oncology Division between January 2000 and December 2009 were retrospectively reviewed.
There were 47 patients with newly diagnosed ovarian tumors. The mean age at presentation was 10.0 ± 3.4 years. The most common symptoms at presentation were acute abdominal pain (48.9%) and abdominal mass (40.4%). Precocious puberty was uncommon (6.3%). Histology was germ cell tumors in 44 cases and nongerm cell tumors in three cases. The benign teratomas (mature and immature grade 1 and 2; n=9) underwent complete surgical resection alone; none had recurrence on follow up. Of the remaining 35 GCTs, 31 patients were given chemotherapy and 4 refused treatment.26 out of the 31 patients completed chemotherapy with BEP (bleomycin, etoposide, cisplatin) regimen with acceptable toxicities. 5 children i.e.; (19.2%) developed recurrence. At a median follow up of 80 months, 10 year disease free survival was 80.8 ± 7.7% and 10 year overall survival was 92.7 ± 4.9%.
Germ cell tumors are the most common ovarian malignancy in children. With surgery and chemotherapy using BEP, good outcome can be expected in these patients.
卵巢肿瘤在儿童时期并不常见，约占儿童恶性肿瘤的1%。三分之二的儿童卵巢肿瘤为生殖细胞肿瘤。上皮性卵巢肿瘤和间质肿瘤则较为少见。我们分享儿童卵巢癌的经验，分析一系列病例的临床特征、治疗及生存情况。
回顾性分析2000年1月至2009年12月在我们儿科肿瘤科室登记的所有14岁以下新诊断卵巢肿瘤患儿。
共有47例新诊断的卵巢肿瘤患者。就诊时的平均年龄为10.0±3.4岁。就诊时最常见的症状是急性腹痛（48.9%）和腹部肿块（40.4%）。性早熟并不常见（6.3%）。组织学检查显示44例为生殖细胞肿瘤，3例为非生殖细胞肿瘤。9例良性畸胎瘤（成熟及不成熟1级和2级；n = 9）仅接受了完整的手术切除；随访期间均无复发。其余35例生殖细胞肿瘤中，31例患者接受了化疗，4例拒绝治疗。31例患者中有26例完成了BEP（博来霉素、依托泊苷、顺铂）方案化疗，毒性可接受。5名儿童（19.2%）出现复发。中位随访80个月时，10年无病生存率为80.8±7.7%，10年总生存率为92.7±4.9%。
生殖细胞肿瘤是儿童最常见的卵巢恶性肿瘤。通过手术及BEP方案化疗，这些患者有望获得良好预后。
