Secondary ovarian neoplasms in children: imaging features with histopathologic correlation.
BACKGROUND
Although the pathologic features and imaging appearance of childhood primary ovarian neoplasms have been well described, little information is available about the malignancies that may secondarily involve the ovary.


OBJECTIVE
To determine the relationship between the imaging features and the histopathology of secondary ovarian neoplasms in children treated at our institution.


METHODS
We searched our institutional database for codes indicating metastatic ovarian disease. Of the 35 patients with such codes, 18 had pathologically proven secondary ovarian disease. From their medical records we recorded demographic data, presenting symptoms, and evidence of endocrine dysfunction. We reviewed the pre-oophorectomy imaging and the subsequent pathologic specimens.


RESULTS
One-third of the patients had bilateral pelvic masses; another third had large masses indistinguishable from the ovaries. Twelve (67%) had either ascites, peritoneal implants, matted bowel, adenopathy, pleural effusions, or some combination of these. Five (28%) had other metastatic disease. Primary tumors included colon adenocarcinoma (9), Burkitt's lymphoma (3), alveolar rhabdomyosarcoma (3), Wilms' tumor (1), neuroblastoma (1), and retinoblastoma (1).


CONCLUSIONS
Although rare, secondary ovarian tumors should be considered in the differential diagnosis of children with ovarian masses. Bilateral ovarian masses or large masses indistinguishable from the ovaries, particularly in the presence of other metastatic foci, may help distinguish primary from secondary ovarian malignancies.
McCarville
M B
MB
Department of Diagnostic Imaging, St. Jude Children's Research Hospital, 332 North Lauderdale, Memphis, TN 38105-2794, USA. beth.mccarville@stjude.org
Hill
D A
DA
Miller
B E
BE
Pratt
C B
CB
D000230:Adenocarcinoma / Q000473:pathology; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000473:pathology; D002051:Burkitt Lymphoma / Q000473:pathology; D002648:Child; D003110:Colonic Neoplasms / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D009447:Neuroblastoma / Q000473:pathology; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D019572:Retinal Neoplasms / Q000473:pathology; D012175:Retinoblastoma / Q000473:pathology; D018232:Rhabdomyosarcoma, Alveolar / Q000473:pathology; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed; D009396:Wilms Tumor / Q000473:pathology