Clinicopathologic Profile, Surgical Practices and Reproductive Outcomes of Malignant Ovarian Neoplasms in Children and Adolescents

BackgroundOvarian malignancies in young females have a pivotal incidence in gynecological oncology.Aims & ObjectivesTo determine the frequency, clinical presentation, tumor characteristics, management, and reproductive outcomes of children and adolescents with ovarian neoplasm below 20 years of age in our Odisha population.Material & methodsThis is a retrospective observational study done in the Department of Gynecologic Oncology, AHPGIC, Cuttack, Odisha. Girls below 20 years with ovarian tumors who had undergone staging laparotomy/cytoreductive surgery at AHPGIC between November 2012 to October 2022 were included.ResultsGirls below the age of 20 with malignant ovarian tumors who had undergone staging or debulking surgery have been included. The mean age in our study was 15.5 years [7-19 years]. Among the 47 malignant cases, only three cases were in the age group below ten years (6.38%). Abdominal distension (52.3%), abdominal pain were the most common complaints in these patients. Most common was stage 1, followed by stage III (13/47 cases) and stage II (11/47 cases). Only four patients had stage IV disease. Of the 47 cases included in our study, 43 cases of staging laparotomy (91.48%) and four cases (8.51%) of interval debulking surgery had been performed. 44/47 cases (93.61%) of fertility preserving surgery have been done. 6.38% (3/47 cases) of TAH BSO with debulking had been done. 11 patients of 47 patients (23.40%) did not receive any chemotherapy. The remaining 36 patients (76.60%) had received chemotherapy. Median follow-up time was 47 months (14-122 mo.). Out of total 47 patients included, seven patients (14.89%) have recurred, and four patients (8.51%) have died till date. 40 patients have been analyzed for their reproductive outcomes. Six term deliveries and two preterm deliveries have been documented till date.ConclusionA pediatric malignant ovarian tumor is a highly treatable condition if it is in an early stage when first diagnosed. Among the malignant ovarian tumors, ovarian germ cell cancers are the commonest, and thus a strong index of suspicion should be advocated in primary care givers who encounter adnexal masses in this age group.