Pediatric ovarian tumors--dilemmas in diagnosis and management.
BACKGROUND
Ovarian tumors are rare in the pediatric age group and thus diagnostic and treatment strategies are heterogeneous. This study aims to evaluate ovarian tumors with a focus on age at presentation, imaging characteristics, diagnostic strategy, tumor presentation and management.


METHODS
Data was collected retrospectively from patients admitted between 1991 and 2008 for the evaluation and therapy of ovarian tumors.


RESULTS
Twenty-five patients were identified with neoplastic ovarian lesions (mean age 10.7 years). Sixteen patients (64%) underwent surgery for benign and 9 (36%) for malignant tumors. Benign tumors (n=16) had a mean diameter of 10.7 cm and mean age at presentation was 9.6 years compared to a diameter of 18.6 cm and 12.3 years in the malignant group (n=9). Elevated tumor markers were observed in 3 (12.5%) benign tumors and in 7 (77.8%) malignant tumors. In preoperative ultrasound investigation, cyst formation was identified in 4 benign tumors and solid tumor mass in 2 malignant tumors. A minimally invasive surgical approach was chosen in two patients, while open surgery was opted for in the rest.


CONCLUSIONS
Cyst formation, small tumor size and younger age at presentation were characteristic of benign tumors. Malignant tumors often presented with elevated tumor markers, a larger size and a solid consistency. Diagnostic dilemmas remain for both tumor groups due to the different tumor types and the heterogeneity of presentation.
Ruttenstock
E M
EM
Medical University of Graz, Pediatric and Adolescents Surgery, Graz, Austria. elke.ruttenstock@gmx.at
Saxena
A K
AK
Schwinger
W
W
Sorantin
E
E
Hoellwarth
M E
ME
D002648:Child; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies