Epithelial ovarian tumors and CA125 in premenarchal girls.
OBJECTIVE
This is a review of our 18-year experience with premenarchal girls with epithelial ovarian tumors. Special attention was focused on the predictive value of CA125 serum levels.


METHODS
Analysis of premenarchal patients with resected or biopsied ovarian masses from 1988 to 2005 was performed. Patient age, clinical presentation, operative procedures, histologic type of tumor, treatment and outcome were obtained.


RESULTS
Six premenarchal girls (aged from 6 to 14 years) were surgically treated for epithelial tumors, representing 13% of all ovarian tumors at this age. Histological findings revealed cystadenoma in four girls, one with a mucinous borderline tumor and one with undifferentiated carcinoma. Tumor volume was higher than 400 cm3 in four girls. Sensitivity, specificity and positive predictive value of CA125 level for ovarian malignant epithelial tumors were 0.50, 0.50, and 0.33, respectively. The premenarchal girl with undifferentiated carcinoma in Stage III died after six months in spite of chemotherapy.


CONCLUSIONS
Ovarian epithelial tumors in premenarchal girls show important growth potential and a relatively high malignancy rate with great influence of borderline neoplasms. CA125 is a tumor marker with low sensitivity and specificity for detection of epithelial ovarian malignancy in this age group.
Stankovic
Z
Z
Department of Pediatric and Adolescent Gynecology, Surgery and Pathology, Mother and Child Health Institute of Serbia.
Djuricic
S
S
Djukic
M
M
Jovanovic
D
D
Vasiljevic
M
M
D000293:Adolescent; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D002277:Carcinoma / Q000097:blood* / Q000473:pathology; D002648:Child; D018282:Cystadenocarcinoma, Mucinous / Q000097:blood / Q000175:diagnosis*; D018293:Cystadenoma, Serous / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008572:Menarche; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen