title: Ovarian neoplasms in children.
abstract: OBJECTIVE
  To review the clinical presentation, treatment, and outcome in a series of children with ovarian neoplasms.
  
  
  METHODS
  A retrospective review of the medical records in a case series of 29 girls with ovarian neoplasms. The length of follow-up ranged from 6 months to 7 1/2 years and averaged 3.0 years in the girls with malignant tumors.
  
  
  METHODS
  The patients were treated at a large referral children's hospital.
  
  
  METHODS
  Twenty-nine girls with ovarian neoplasms were treated from 1976 to 1992. The average age of the patients was 10 years and ranged from 2 to 16 years.
  
  
  METHODS
  The principal outcomes examined were mortality and surgical morbidity.
  
  
  RESULTS
  The most common presenting symptoms for these ovarian tumors in pediatric patients included chronic abdominal pain, an abdominal mass, or distention. Three girls presented with precocious puberty or hirsutism. In 27 cases, the tumor was a primary ovarian lesion. In two patients, the ovarian mass was the presenting finding for a stage IV non-Hodgkin's lymphoma. Seventeen tumors were benign and 12 were malignant. Tumors originating from the germ-cell line predominated (n = 17). Seven of the 10 ovarian malignant neoplasms were stage I at the time of diagnosis. All but one of the girls with malignant tumors received either adjunctive radiation therapy or multiple-agent chemotherapy. Two girls with sex cord/stromal cell tumors who presented with stage I disease ultimately developed widespread metastases. Both girls with large epithelial tumors survived. All of the girls with benign tumors and seven (70%) of 10 with malignant lesions survived.
  
  
  CONCLUSIONS
  Ovarian tumors are unusual lesions in the pediatric population. Unlike in adults, such neoplasms generally originate from the germ-cell line. Whereas most ovarian tumors in girls are benign, some children have malignant tumors that are very aggressive and do not respond well to adjuvant therapy. In particular, malignant sex cord/stromal cell tumors, even when they present at an early stage, may behave unpredictably.
authors.affiliation: Department of Surgery, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis.
authors.forename: M A
authors.initials: MA
authors.lastname: Skinner
authors.forename: M G
authors.initials: MG
authors.lastname: Schlatter
authors.forename: S A
authors.initials: SA
authors.lastname: Heifetz
authors.forename: J L
authors.initials: JL
authors.lastname: Grosfeld
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome