Review of ovarian tumors in children and adolescents: radiologic-pathologic correlation.
The incidence, histologic distribution, and clinical manifestations of ovarian tumors in the pediatric population are distinct from those in adults. Although ovarian neoplasms in childhood and adolescence are rare, the diagnosis should be considered in young girls with abdominal pain and a palpable mass. Differential diagnosis in children and adolescents with ovarian tumors should be conducted on the basis of unique clinical manifestations, elevated serum tumor marker levels, and distinctive imaging findings. Although the clinical manifestations are nonspecific and may overlap, they may assist in diagnosis of some types of ovarian tumors. Children who present with a palpable mass or symptoms of precocious puberty have a high likelihood of malignancy. Many ovarian tumors are associated with abnormal hormonal activity and/or abnormal sexual development. Elevated levels of serum tumor markers, including α-fetoprotein, the beta subunit of human chorionic gonadotropin, and CA-125, raise concern for ovarian malignancies. However, negative tumor markers do not exclude the possibility of malignancy. Identification of imaging features at ultrasonography, computed tomography, and magnetic resonance imaging can help differentiate benign from malignant ovarian tumors and, in turn, plays a crucial role in determining treatment options. At imaging, malignant ovarian tumors usually appear predominantly solid or heterogeneous and are larger than benign tumors. Because surgery is the primary treatment for ovarian tumors, ovarian salvage with fertility preservation and use of a minimally invasive surgical technique are important in children and adolescents.
From the Departments of Radiology (S.H.H., J.W.K., S.I.J., H.S.L., Y.Y.J., H.K.K.) and Obstetrics and Gynecology (W.D.K.), Chonnam National University Hwasun Hospital, Chonnam National University Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do 519-763, Republic of Korea; and Departments of Radiology (S.S.S.) and Pathology (Y.D.C., K.H.L.) and Center for Aging and Geriatrics (S.S.S.), Chonnam National University Hospital, Chonnam National University Medical School, Jeollanam-do, Republic of Korea.
Suk Hee
SH
Heo
Jin Woong
JW
Kim
Sang Soo
SS
Shin
Seo In
SI
Jeong
Hyo Soon
HS
Lim
Yoo Duk
YD
Choi
Kyoung Hwa
KH
Lee
Woo Dae
WD
Kang
Yong Yeon
YY
Jeong
Heoung Keun
HK
Kang
D000293:Adolescent; D014408:Biomarkers, Tumor / Q000032:analysis; D002648:Child; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
D014408:Biomarkers, Tumor