Original Article
Metachronous benign ovarian tumors are not uncommon in children

https://doi.org/10.1016/j.jpedsurg.2013.09.019Get rights and content

Abstract

Purpose

To evaluate the risk for metachronous ovarian tumor in pediatric patients with mature ovarian teratoma.

Methods

During 1981–2011, 22 children underwent oophorectomy for mature teratoma at the median age of 11.4 (range 1.5–15.3) years. The patients were followed-up in median 4.4 (range 0.5–25.5) years.

Results

None of the patients had synchronous bilateral tumor at the time of primary operation, but during follow-up five patients (23%) got metachronous contralateral ovarian tumor. The contralateral tumor was observed in median 3.6 (range 1–8.8) years after the primary operation. According to Kaplan–Meier analysis the risk for contralateral tumor was 14% ± 8% (SE) within five years and 66% ± 26% (SE) within 10 years. In this series, the contralateral tumor was operated by ovary preserving surgery. Three of the metachronous tumors were mature teratomas and two were seromucinous infantile cystadenomas. One patient had a second teratoma recurrence 14 years after the first recurrence.

Conclusions

More than one fifth of the children with ovarian mature teratoma get metachronous benign tumor to the contralateral ovary. Therefore a yearly ultrasound follow-up is needed for these patients up to potential pregnancy to enable early diagnosis, ovary preserving surgery and maintenance of fertility in the case of metachronous tumor.

Section snippets

Methods

This retrospective study was performed in the Children’s Hospital of Helsinki University Central Hospital. We identified from the hospital database altogether 46 patients operated for an ovarian neoplastic tumor during 1981–2011. Twenty-two (48%) of them had mature teratoma.

The clinical data of the diagnostic and operative procedures as well as follow-up data were collected from the hospital medical and surgical records. The ovarian tissue samples were re-evaluated by one of the researchers

Results

The median age of the 22 patients with mature teratoma was 11.4 (range 1.5–15.3) years at primary surgery. Preoperative diagnostic evaluation was done with ultrasonography for all 22 patients, with confirmation by magnetic resonance imaging for 11 patients and with computed tomography for 4 patients. None of the patients had tumor on the contralateral ovary either in preoperative imaging or in peroperative examination. Contralateral ovarian biopsy was performed in one patient during the primary

Discussion

In this retrospective study, we observed that the patients operated for ovarian mature teratomas during childhood are in a substantial risk of having benign neoplastic tumors in the contralateral ovary later in life.

Ovarian neoplasms are rare in children. In our 30 years’ material, 46 patients with ovarian neoplasms were diagnosed in a population of about 18,000 newborns yearly. Almost half of the primary tumors were mature teratomas, fitting to the previous observations [9], [10]. In our study,

References (16)

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