Pediatric ovarian neoplastic tumors: incidence, age at presentation, tumor markers and outcome

abstract

OBJECTIVE:

To investigate the incidence, age of onset and tumor marker levels in benign and malignant pediatric ovarian neoplastic tumors. Design. Retrospective database study.

SETTING:

Single center study.

POPULATION:

Forty-five 0-15 year old patients operated on for ovarian neoplastic tumors from the beginning of 1999 to the end of 2013.

METHODS:

Serum alpha-fetoprotein, human chorionic gonadotropin and cancer antigen-125 levels as well as follow-up data were recorded from patient charts and tumor histology was re-evaluated.

MAIN OUTCOME MEASURES:

Incidence of ovarian neoplastic tumors in the pediatric population. Differences in patient characteristics and tumor marker levels between those with benign and malignant tumors.

RESULTS:

The annual incidence of ovarian tumors was 2.2/100 000 females. Median age at presentation was 13.0 years (range 0.9-15.7), similar in both the 33 (73%) with a benign and the 12 patients (27%) with a malignant tumor. The tumors with the highest propensity to metastase (yolk sac tumors, mixed germ cell tumors, small cell carcinoma) were only found in girls >9 years. Elevated serum alpha-fetoprotein and cancer antigen-125 values associated more often with malignant tumors (p<0.001 and 0.031, respectively). There were no deaths or local recurrences. Four patients with a mature teratoma developed a contralateral benign ovarian tumor during follow-up.

CONCLUSIONS:

Both benign and malignant ovarian tumors are rare in the pediatric population, but the incidence increases with age. High alpha-fetoprotein and cancer antigen-125 levels were associated with malignant tumors. The prognosis of the pediatric ovarian tumors seems to be favorable.