Pommert Lauren, Bradley William
Children's Hospital of Wisconsin, Department of Pediatrics, Hematology/Oncology/BMT, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
Department of Obstetrics and Gynecology, Froedtert and the Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
Curr Oncol Rep. 2017 Jul;19(7):44. doi: 10.1007/s11912-017-0604-7.
Three primary categories of gynecologic cancer are found in pediatric and adolescent patients: stromal carcinomas including juvenile granulosa cell tumors and Sertoli-Leydig cell tumors, rhabdomyosarcomas arising from the vagina and cervix (sarcoma botryoides), and ovarian germ cell tumors which comprise a wide range of histologies. These entities are rare and treatment approaches have focused on decreasing late effects of chemotherapy treatment. Here, we review presentation, histologic classifications, diagnosis, and treatment recommendations for pediatric gynecologic cancers.
Event-free and overall survival for these cancers is high, and the goals of treatment are minimization of morbidity and preservation of fertility with unilateral salpingo-oophorectomies and limited staging. Surveillance of tumor markers after surgery is helpful in monitoring for disease progression and adjuvant chemotherapy is often reserved for patients at recurrence. Recent literature supports avoiding chemotherapy even in high-grade germ cell tumors in the pediatric population.
儿科和青少年患者中发现的妇科癌症主要有三类：间质癌，包括青少年颗粒细胞瘤和支持-间质细胞瘤；源自阴道和宫颈的横纹肌肉瘤（葡萄状肉瘤）；以及组织学类型广泛的卵巢生殖细胞肿瘤。这些实体瘤较为罕见，治疗方法主要集中在减少化疗的远期影响。在此，我们综述儿科妇科癌症的临床表现、组织学分类、诊断及治疗建议。
这些癌症的无事件生存率和总生存率较高，治疗目标是将发病率降至最低，并通过单侧输卵管卵巢切除术和有限分期来保留生育能力。术后监测肿瘤标志物有助于监测疾病进展，辅助化疗通常仅用于复发患者。最近的文献支持即使在儿科人群的高级别生殖细胞肿瘤中也避免化疗。
