title: Ovarian germ cell tumors in children: a clinical study of 66 patients.
abstract: BACKGROUND
  Ovarian germ cell tumors are rare in childhood. The aim of this study is to review clinical presentation, management, and outcome in a two-center series of girls with ovarian germ cell tumor.
  
  
  METHODS
  The records of 66 patients (median age 9 years) with histologically proven ovarian germ cell tumor (either benign or malignant), treated over a 44-year-span, were reviewed.
  
  
  RESULTS
  Pain and an abdominal mass were the most frequent symptoms. The tumors were right-sided in 35, left-sided in 28, and bilateral in 3. Most patients (52) were stage I, 4 were stage II, 6 stage III, and 1, with liver metastases, stage IV. Sixteen patients had an emergency operation for tumor torsion. Unilateral salpingo-oophorectomy was the most frequently performed procedure (n = 46), and ovarian-sparing tumorectomy was performed in 9 patients (one bilaterally). Histologically, teratomas were found most frequently (mature: 45, immature: 9), followed by mixed tumors (n = 7), yolk sac tumors (n = 3), dysgerminoma (n = 2), gonadoblastoma (n = 2), and embryonal carcinoma (n = 1). Surgical removal of the tumor with or without the ovary and/or adnex was the sole treatment in 55 patients, chemotherapy was administered in 10 and radiotherapy + chemotherapy in one. Intra-operative spillage of tumoral fluid occurred in six; this did not influence outcome in five. Recurrence was observed in three patients. Two patients, with malignant disease, died. The 64 survivors are now between 8 months and 44 years after treatment.
  
  
  CONCLUSIONS
  With a recurrence rate of 4.5% and a mortality rate of 3%, this series confirms the excellent prognosis for girls with ovarian germ cell tumor (GCT).
authors.affiliation: Department of Pediatric Surgery, Academic Hospital, Free University of Brussels, Brussels, Belgium. antoine.debacker@az.vub.ac.be
authors.forename: Antoine
authors.initials: A
authors.lastname: De Backer
authors.forename: Gerard C
authors.initials: GC
authors.lastname: Madern
authors.forename: J Wolter
authors.initials: JW
authors.lastname: Oosterhuis
authors.forename: Friederike G A J
authors.initials: FG
authors.lastname: Hakvoort-Cammel
authors.forename: Frans W J
authors.initials: FW
authors.lastname: Hazebroek
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome