Clinicopathological Observation on Ovarian Tumors in Premenarcheal Years

Shim, S I; Hur, S Y; Lee, G SR; Kim, S J; Kim, E J; Song, S K; Namkoong, S E; Kim, S P

Abstract

We retrospectively evaluated the clinical presentation and histopathologic findings of ovarian tumors in premenarcheal years. Twenty-seven premenarcheal girls with ovarian tumors were treated surgically at the Department of Obstetrics and Gynecology, Catholic University hospital, from 1987 to 1997. The results were as follows : 1. Among 5046 cases undergoing ovarian surgery, 27 (0.54%) was diagnosed as ovarian tumor in premenarcheal years. 2. Of 27 premenarcheal ovarian tumors, 19 (70.3%) were benign tumors, 7 (26.0%) were malignant tumors and one (3.7%) was follicular cyst. 3. The ovarian benign tumors included 17 benign teratoma and 2 serous cystadenoma. The ovarian malignant tumors included 6 germ cell tumor (three dysgerminoma, two malignant teratoma, one endodermal sinus tumor) and 1 granulosa cell tumor. 4. Ovarian tumors in premenarcheal years presented at a mean age of 10 years and ranged from 1 month to 14 years. 5. The symptoms of ovarian tumors were abdominal pain or discomfort (70.3%), palpable abdominal mass (18.6%), genital bleeding (7.4%), gastrointestinal symptoms (3.7%) in the order of frequency and there were no asymptomatic cases. 6. Tumor size varied from 4 to 20 cm. Mean size of ovarian benign tumors was 7.5 cm in diameter. Mean size of ovarian malignant tumors was 13 cm in diameter. 7. The most common erroneous preoperative diagnosis was appendicitis (7.4%). 8. The complications of ovarian tumors were torsion (44.4%), rupture (3.7%), ascites (11.1%) and pelvic adhesion (18.5%). 9. Six of 7 ovarian malignant tumors were FIGO stage I at the time of diagnosis. And one patient with endodermal sinus tumor was FIGO stage IV. 10. Surgical treatment for ovarian benign tumors consisted generally of a unilateral salpingo-oophorectomy, unilateral oophorectomy or cystectomy. Ovarian malignant tumors were treated with unilateral salpingo-oophorectomy, but two teratoma and one endodermal sinus tumor were followed by adjuvant chemotherapy. On follow-up, one of the girls with malignancies died (endodermal sinus tumor) and another is well.