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Otsuka I. Primary Retroperitoneal Carcinomas: New Insights into Pathogenesis and Clinical Management in Comparison with Ovarian Carcinomas and Carcinoma of Unknown Primary. Cancers (Basel) 2023; 15:4614. [PMID: 37760583 PMCID: PMC10526425 DOI: 10.3390/cancers15184614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/07/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
Primary retroperitoneal carcinomas are very rare tumors. Their pathogenesis remains unknown but may be associated with that of ovarian carcinomas, considering the similarity in morphology and gender preference. Although metaplasia of coelomic epithelium is the most widely accepted theory, the pathogenesis of retroperitoneal carcinomas may differ by histologic subtype, like ovarian carcinomas. Mucinous carcinoma, which develops in both women and men, may originate in both primordial germ cells and Walthard cell nests that may be derived from the fallopian tube. Serous carcinomas may be associated with endosalpingiosis, the presence of fallopian tube-like epithelium outside the fallopian tube, and a remnant Müllerian tract. Endometrioid and clear cell carcinomas appear to be associated with extraovarian endometriosis. Additionally, both carcinomas in the retroperitoneal lymph nodes may be metastatic diseases from endometrial and/or renal cell cancer that regress spontaneously (carcinoma of unknown primary). Retroperitoneal carcinomas are difficult to diagnose, as they have no characteristic symptoms and signs. Surgery is the cornerstone of treatment, but the necessity of chemotherapy may depend on histological subtype. Further studies are necessary, in particular studies on endosalpingiosis, as endosalpingiosis is a poorly understood condition, although it is associated with the development of both serous and mucinous carcinomas.
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Affiliation(s)
- Isao Otsuka
- Department of Obstetrics and Gynecology, Kameda Medical Center, Kamogawa 296-8602, Japan
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2
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Alsolami FN, Alfraidi LS, Alharbi IM, Alsayafi SI, Alharbi A. Large Ovarian Cystadenoma in an Adolescent Girl: A Case Report. Cureus 2023; 15:e43108. [PMID: 37692598 PMCID: PMC10483259 DOI: 10.7759/cureus.43108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Ovarian cystadenomas are rare neoplastic tumors arising from the ovarian surface epithelium. While commonly observed in adult women, their occurrence in adolescents is exceedingly uncommon. The management of large ovarian cystadenomas in this age group poses unique challenges due to acute presentations and potential complications. We present the case of a 16-year-old girl who presented with sudden, severe abdominal pain and distension. Imaging revealed a 15 cm complex cystic mass originating from the right ovary, consistent with a cystadenoma. Urgent surgical intervention led to the right salpingo-oophorectomy, confirming the benign nature of the tumor. This report highlights the importance of a comprehensive approach to diagnosing and managing rare ovarian neoplasms in adolescents. Timely recognition, appropriate imaging, histopathological evaluation, and surgical intervention are crucial for optimal outcomes and reducing potential complications.
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Affiliation(s)
| | | | | | | | - Ahlam Alharbi
- Family Medicine, Primary Health Care Center, Riyadh, SAU
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3
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Li Q, Zou C, Xu Y, Liu S, Yan T. Mucinous cystadenocarcinoma of the ovary in a 14-year-old girl: a case report and literature review. BMC Womens Health 2023; 23:382. [PMID: 37479970 PMCID: PMC10362768 DOI: 10.1186/s12905-023-02551-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/16/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Ovarian epithelial tumors are common in adults, and their peak incidence of onset is over 40 years of age. In children, most ovarian tumors are germ cell-derived, whereas epithelial tumors are rare and mostly benign. CASE PRESENTATION This report describes a case of a 14-year-old Chinese girl with ovarian mucinous cystadenocarcinoma. She was admitted with a small amount of bloody vaginal discharge during the past month. Magnetic resonance imaging of the abdomen and pelvis showed a large solid cystic mass lesion in the left ovary. Tumor marker levels were within normal limits ( CA-125: 22.3 U/mL, HE4: 28.5 pmol/L, HCG: < 1.20 mIU/ml, AFP: 3.3 ng/ml, CEA: 2.2 ng/ml, CA19-9: < 2.0 U/mL). Laparoscopic exploration revealed a large left ovarian tumor. The patient underwent left salpingo-oophorectomy, and showed no significant issues during follow-up, as well as no evidence of recurrence or metastasis. CONCLUSIONS We report the first pediatric case of ovarian mucinous cystadenocarcinoma in China. Given the scarcity of reports addressing the clinical management of this condition, the present study provides a useful contribution to its further understanding in light of developing future treatment strategies.
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Affiliation(s)
- Qiong Li
- Department of Pathology, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, No. 120 Longshan Rd, Yubei District, Chongqing, 401147, China
| | - Cancan Zou
- Department of Pathology, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, No. 120 Longshan Rd, Yubei District, Chongqing, 401147, China
| | - Yangyang Xu
- Department of Radiology, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Shiqing Liu
- Department of Ultrasound, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Tianjing Yan
- Department of Pathology, Chongqing Health Center for Women and Children, Women and Children's Hospital of Chongqing Medical University, No. 120 Longshan Rd, Yubei District, Chongqing, 401147, China.
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4
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A Huge Ovarian Mucinous Cystadenoma in a 15-Year-Old Girl with Situs Inversus Totalis: Report of a Rare Case. J Pediatr Adolesc Gynecol 2021; 34:88-91. [PMID: 32688052 DOI: 10.1016/j.jpag.2020.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/15/2020] [Accepted: 07/09/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Ovarian mucinous cystadenomas with situs inversus totalis are infrequent in pubertal girls. Surgical techniques on their treatment without affecting ovary anatomical and physiological function have always been a great challenge. CASE A 15-year-old girl presented with abdominal distension and pain due to some huge growths. Computed tomography imaging showed that the heart and whole abdomen viscera were inversely located. Two big low-density masses were found in the abdominopelvic cavity. An exploratory laparotomy was performed and 2 tumors were removed. Pathology confirmed a mucinous cystadenoma. SUMMARY AND CONCLUSION Ovarian mucinous cystadenomas with situs inversus totalis can be detected with detailed physical and radiological examination. For adolescent female patients, particular attention should be paid to protect the reproductive anatomical structure during surgery.
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Raźnikiewicz A, Korlacki W, Grabowski A. Evaluation of the usefulness of laparoscopy in the diagnosis and treatment of adnexal pathologies in the pediatric population. Wideochir Inne Tech Maloinwazyjne 2020; 15:366-376. [PMID: 32489499 PMCID: PMC7233164 DOI: 10.5114/wiitm.2020.93998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The current trend in adnexal surgery in children is to minimize the invasiveness of diagnostic and therapeutic procedures, reduce the number of complications and reduce the risk of infertility. AIM Evaluation of the usefulness and effectiveness of laparoscopy in diagnostics and treatment of pathological lesions of adnexa in the pediatric population and evaluation of the correlation of imaging with the intraoperative diagnosis during laparoscopy. MATERIAL AND METHODS The study included 89 patients aged 0-18 years (mean: 12.62) who underwent an emergency or elective laparoscopic procedure due to the suspicion of adnexa pathology in the imaging tests or in which intraoperative pathology of the adnexa was found without previous suspicion of these changes in the imaging tests. Patients were divided into 2 groups according to the procedure (emergency or elective) and into 4 age groups. RESULTS The most frequent postoperative diagnosis was an adnexal cyst and ovarian tumor. The ratio of malignant to benign lesions was 0.087. In 32.58% of patients appendix pathology was found. Coexistence of adnexa and appendix pathology was statistically significantly more frequent in patients undergoing emergency surgery (p = 0.013). There was no correlation between the size of the tumor or ovarian cyst and the occurrence of adnexal torsion, and no correlation between the size of the tumor and the degree of torsion of the adnexa. Three conversions were performed. The average operation time was 63.7 min. CONCLUSIONS Laparoscopic diagnosis and treatment of adnexal pathology seems to be safe due to the low percentage of perioperative complications. It shows high sensitivity in recognizing adnexal pathologies and other defects.
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Affiliation(s)
- Aleksandra Raźnikiewicz
- Department of Children's Developmental Defects Surgery and Traumatology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Wojciech Korlacki
- Department of Children's Developmental Defects Surgery and Traumatology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Andrzej Grabowski
- Department of Children's Developmental Defects Surgery and Traumatology, Medical University of Silesia in Katowice, Zabrze, Poland
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Watanabe S, Nagashima S, Onagi C, Yamazaki N, Shimada S, Sakai M, Yanai S, Haga Y, Ohara A, Kuroiwa M. Treatment strategy for pediatric giant mucinous cystadenoma: A case report. Pediatr Rep 2019; 11:8190. [PMID: 31579185 PMCID: PMC6769354 DOI: 10.4081/pr.2019.8190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/05/2019] [Indexed: 11/23/2022] Open
Abstract
Because of their rarity, the treatment strategy for pediatric ovarian epithelial tumors is controversial, especially for a giant cystadenoma. We report the largest mucinous cystadenoma (MCA) case in the pediatric literature thus far. A 12-year-old girl had abdominal distention and visited our hospital. She had a multilocular cyst with some protuberance on the inside and high values of CA 19-9 and CA-125. We diagnosed her with a left MCA and performed a left oophorectomy. The tumor was the stage IA borderline malignant MCA and weighed 11.8 kg. Five years have passed, the patient has not experienced recurrence or metastasis. The resection of giant tumors can affect respiration and circulation. However, pre- or intra-operative drainage may lead to dissemination and adhesion. When we treat pediatric giant ovarian epithelial tumors, we must understand the findings that suggest the possibility of malignancy to decide appropriately as to whether drainage should be performed.
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Affiliation(s)
- Shun Watanabe
- Department of Surgery, Toho University School of Medicine, Tokyo.,First Department of Surgery, Dokkyo Medical University, Tochigi
| | | | - Chihiro Onagi
- Department of Surgery, Toho University School of Medicine, Tokyo
| | - Nobuto Yamazaki
- Department of Surgery, Toho University School of Medicine, Tokyo
| | - Shuhei Shimada
- Department of Surgery, Toho University School of Medicine, Tokyo
| | - Masato Sakai
- Department of Surgery, Toho University School of Medicine, Tokyo
| | - Shun Yanai
- Department of Pediatrics, Toho University School of Medicine, Tokyo, Japan
| | - Yoichi Haga
- Department of Pediatrics, Toho University School of Medicine, Tokyo, Japan
| | - Akira Ohara
- Department of Pediatrics, Toho University School of Medicine, Tokyo, Japan
| | - Minoru Kuroiwa
- Department of Surgery, Toho University School of Medicine, Tokyo
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7
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8
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Alsuhaibani M, Al Harbi M, Al-lababidi NH, Almuzaini AS, Alsulaiman A, Aljadaan SA. Ovarian lesions among pediatric patients: A tertiary center experience (1997-2016). Int J Pediatr Adolesc Med 2017; 4:129-132. [PMID: 30805516 PMCID: PMC6372493 DOI: 10.1016/j.ijpam.2017.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/08/2017] [Accepted: 08/09/2017] [Indexed: 11/22/2022]
Abstract
Introduction Ovarian lesions are not commonly seen in pediatric females; however, there are some reported cases among different pediatric age groups. Ovarian lesions can show, clinically, in many diverse presentations, and the treatment chosen may be conservative or surgical, accordingly. In this study, we aim to find ovarian lesions commonly operated on and their histopathological and clinical characteristics among pediatric patients at tertiary center in Riyadh, Saudi Arabia. Material and methods A retrospective review of medical records of all pediatric patients (aged 14 or younger) who underwent surgical removal of ovarian lesions from January 1997 to August 2016 at King Abdulaziz Medical City, Riyadh, Saudi Arabia was conducted. Results Records for a total of 14 girls with a mean age of 5.7 ± 5.1 years were reviewed. The most common clinical presentation was acute abdominal pain (n = 5, 35.7%). There were four patients without any complaints who were diagnosed incidentally (28.6%). More than half of the patients underwent laparoscopy (n = 8, 57.1%) and cystectomy procedures were performed on 50% of the patients (n = 7). Simple ovarian cysts (n = 5) were the most common ovarian lesions followed by mature cystic teratomas (n = 3) with 35.7% and 21.4%, respectively. Furthermore, simple ovarian cysts were more common among infants. There was only one death reported and she had been diagnosed with a mixed germ cell tumor. Conclusion The majority of ovarian lesions in the studied pediatric patients were benign. The most common lesions were simple ovarian cysts. Abdominal pain was the most common presenting symptom.
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Affiliation(s)
- Marya Alsuhaibani
- College of Medicine, Qassim University, Buraidah, Qassim, Saudi Arabia
- Corresponding author.
| | - Majed Al Harbi
- College of Medicine, Almaarefa Colleges for Science and Technology, Riyadh, Saudi Arabia
| | | | - Alaa Sunaid Almuzaini
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Saud A. Aljadaan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Pediatric Surgery, King Abdullah Specialist Children Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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A Novice User of Pediatric Emergency Point-of-Care Ultrasonography Avoids Misdiagnosis in a Case of Chronic Abdominal Distention. Pediatr Emerg Care 2016; 32:116-9. [PMID: 26835571 DOI: 10.1097/pec.0000000000000707] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 13-year-old adolescent girl with chronic abdominal distention was referred to the pediatric emergency department after the outpatient workup suggested moderate ascites. Point-of-care ultrasonography performed by the emergency physicians ruled out ascites, instead demonstrating a well-circumscribed cystic mass subsequently identified as an ovarian mucinous cystadenoma.
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10
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Biçer S, Erkul Z, Demiryilmaz I, Peker N. A 9-kg ovarian mucinous cystadenoma in a 14-year-old premenarchal girl. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:326-9. [PMID: 25082433 PMCID: PMC4122110 DOI: 10.12659/ajcr.890862] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PATIENT Female, 14. FINAL DIAGNOSIS Ovarian mucinous cystadenoma. SYMPTOMS Abdominal enlargement • abdominal pain • constipation. MEDICATION -. CLINICAL PROCEDURE -. SPECIALTY Obstetrics and Gynecology. OBJECTIVE Rare disease. BACKGROUND Although ovarian tumors are most commonly observed in adults, they relatively rarely occur in children. The majority of ovarian masses encountered in the premenarchal or childhood stages are non-neoplastic lesions such as benign functional cysts. Epithelial tumors account for 8-10% of all ovarian tumors and are histologically classified as mucinous or serous. The most common benign epithelial ovarian tumor is cystadenoma. CASE REPORT We report the case of a 14-year-old premenarchal girl with chronic abdominal pain, constipation, and abdominal enlargement. A computed tomography detected a huge left ovarian cystic tumor. A 9-kg ovarian tumor was removed surgically. Pathology showed a benign mucinous cystadenoma (MCA). CONCLUSIONS Ovarian neoplasms in children present a diagnostic quandary, and very often the diagnoses are missed or delayed. When the diagnosis is made, a prompt and fertility-preserving surgical treatment must be performed and followed to prevent recurrence.
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Affiliation(s)
- Senol Biçer
- Department of Pediatric Surgery, Erzincan University, Medical School, Erzincan, Turkey
| | - Zehra Erkul
- Department of Pathology, Gümüshane State Hospital, Gümüshane, Turkey
| | - Ismail Demiryilmaz
- Department of General Surgery, Erzincan University, Medical School, Erzincan, Turkey
| | - Necla Peker
- Department of Pediatrics, Erzincan University Medical School, Erzincan, Turkey
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11
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Fan R. Unique features and insights from mucinous tumors of ovary in childhood: clinicopathological study of 15 cases including four premenarchal cases. Fetal Pediatr Pathol 2014; 33:166-75. [PMID: 24575832 DOI: 10.3109/15513815.2014.888111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mucinous tumors of ovary are primarily diagnosed in middle-aged and elder woman. They are very infrequent in the first two decades of life and exceedingly rare in premenarchal girls. We reviewed the past 20 years of our institutional pathology files and studied the clinicopathological features of the childhood ovarian mucinous tumor cases. The study concluded that ovarian mucinous tumor cases in childhood, including premenarchal cases, may not be as rare as people previously estimated and discovered some unique features of the tumors in this age group that are beneficial for better prognosis prediction and clinical management, as well as better understanding of pathogenesis of ovarian epithelial tumors.
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Affiliation(s)
- Rong Fan
- Department of Pathology, Indiana University, IN, USA
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12
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Höhne S, Milzsch M, Stiefel M, Kunze C, Hauptmann S, Finke R. Ovarian borderline tumors in pre-menarche girls. Pediatr Hematol Oncol 2013; 30:253-62. [PMID: 23480305 DOI: 10.3109/08880018.2013.774450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
By reason of a new case of an ovarian mucinous borderline tumor (BOT) in a pre-menarche girl, a research of current literature was implemented. Low-grade malignant epithelial tumors are extremely rare in young children and, as far as we know, only a few case reports exist. The patients presented with vomiting, pain, and a swollen lower abdomen. Pre-operative diagnosis primarily consists of imaging techniques. At Stage Ia, the tumor is confined to the ovary without penetration of the capsule, no malignant ascites or peritoneal implants. Treatment consists of removal of the tumor combined with concurrent salpingo oophorectomy, appendectomy, omentectomy, and peritoneal lavage. Although the treatment recommendations are not uniform, basically, preservation of fertility is the main objective. The prognosis is very good, but recurrence is possible even after 10 years.
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Affiliation(s)
- Sven Höhne
- Clinic of Pediatric Surgery, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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13
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Cevik M, Guldur ME. An extra-large ovarian mucinous cystadenoma in a premenarchal girl and a review of the literature. J Pediatr Adolesc Gynecol 2013; 26:22-6. [PMID: 22854108 DOI: 10.1016/j.jpag.2012.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 04/14/2012] [Accepted: 04/16/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Epithelial ovarian neoplasms are extremely uncommon in children. Ovarian mucinous cystadenoma is benign and an extremely rare presentation in the premenarchal period. We present a case of giant mucinous cystadenoma of the left ovary in a 13-year-old and a review of the supporting literature. CASE REPORT The patient was admitted with a history of increasing abdominal distension and pain for approximately 3 months and a history of an ovarian mass for 3 years. An adnexal mass measuring 40 × 30 × 20 cm was detected by abdominal ultrasonography and computed tomography. The tumor markers CEA, CA 19-9, and CA-125 were elevated, although α-fetoprotein and human chorionic antigen levels were within the normal range. The patient underwent surgery. The smooth-surfaced mass filled the abdomen. A frozen section biopsy was performed, and the results indicated a benign mucinous cystadenoma. A unilateral oophorectomy with tumor removal was performed. CONCLUSION The ovarian mass was revealed by abdominal distension, and a diagnosis was established by frozen biopsy. Complete and careful surgical resection provides satisfactory results; however, careful follow-up is required.
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Affiliation(s)
- Muazez Cevik
- Harran University, Faculty of Medicine, Department of Pediatric Surgery, Sanliurfa, Turkey.
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14
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Willems RPP, Slangen B, Busari JO. Abdominal swelling in two teenage girls: two case reports of massive ovarian tumours in puberty. BMJ Case Rep 2012; 2012:bcr.11.2011.5143. [PMID: 22605874 DOI: 10.1136/bcr.11.2011.5143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The following report describes two 15-year-old girls with a giant abdominal swelling. Signs and symptoms differed between those two girls, as serum tumour markers showed different elevation patterns. Additional investigations including a CT scan and a MRI scan were performed and revealed masses originating from the ovary. Histopathological evaluation after cystectomy showed a mature teratoma and a mucinous cystadenoma.
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Affiliation(s)
- Rick P P Willems
- Pediatrics Department, Atrium Medical Center, Heerlen, Netherlands
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15
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Ishikawa H, Kiyokawa T, Takatani T, Wen WG, Shozu M. Giant multilocular sex cord tumor with annular tubules associated with precocious puberty. Am J Obstet Gynecol 2012; 206:e14-6. [PMID: 22000894 DOI: 10.1016/j.ajog.2011.09.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 09/20/2011] [Indexed: 11/20/2022]
Abstract
We report a case of sex cord tumor with annular tubules featuring a giant multilocular cyst, grossly similar to cystadenoma, in the ovary of an 8.5 year old girl. Estrogen-related symptoms, including precocious puberty and irregular uterine bleeding, immediately improved after tumor resection.
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Affiliation(s)
- Hiroshi Ishikawa
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Japan.
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16
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Matsushita Y, Yokoyama Y, Taniguchi R, Abe K, Watanabe J, Mizunuma H. A case of ovarian mucinous adenocarcinoma in a premenarcheal girl. Int J Clin Oncol 2011; 17:517-21. [PMID: 22016113 DOI: 10.1007/s10147-011-0333-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 09/25/2011] [Indexed: 11/28/2022]
Abstract
We report a case of a 12-year-old premenarcheal girl who developed ovarian mucinous adenocarcinoma. The tumor, which originated from the right ovary, weighed 1400 g, and had a smooth surface and thin capsule, was extirpated. The cut surface showed multilocular cysts of various sizes and yellowish gelatinous to solid parts that accounted for approximately 40% of the cut surface. The histological findings showed a continuous mixture of mucinous adenoma, mucinous borderline tumor, and mucinous adenocarcinoma with an expansile invasive pattern. It was assumed that an ovarian mass developed in an early period after birth or infancy, and the mutation of certain oncogens occurred in an early period, leading to cancer. While some etiological hypotheses concerning ovarian carcinogenesis have been suggested, we believe this case provides valuable information when considering a new onset mechanism of ovarian epithelial malignant tumors.
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Affiliation(s)
- Yoko Matsushita
- Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
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Bhattacharyya NK, De A, Bera P, Sristidhar M, Chakraborty S, Bandopadhyay R. Ovarian tumors in pediatric age group - A clinicopathologic study of 10 years' cases in West Bengal, India. Indian J Med Paediatr Oncol 2011; 31:54-7. [PMID: 21209765 PMCID: PMC2970935 DOI: 10.4103/0971-5851.71656] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background and objectives: Objective in this retrospective study is to find out the incidence of different ovarian tumors of girls up to 20 years of age observed in last ten years in North Bengal Medical College and to correlate clinical and gross findings with histopathologic findings and to compare the incidence with other studies and follow-up of patients with malignant ovarian tumors. Materials and Methods: Findings were retrieved from records of different pathological reports and clinical reports. Results: Total 151 cases of ovarian tumors were received in pathology department in which 34 cases were malignant (22.6%). Amongst malignant cases, 66% are of germ-cell origin–dysgerminoma being the commonest. Strikingly we got 9 cases of malignant surface epithelial tumor. As per follow-up records most of the dysgerminoma came in stage IA and recovered fully following chemotherapy and radiotherapy. Amongst other malignant tumors, few lost the follow-up management and others expired due to metastasis. Conclusions: Patients from hilly areas of North Bengal and low socio-economic status led to lower detection rate of ovarian tumors in early stage which are absolutely necessary for proper guidelines of management to reduce mortality.
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18
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Shah RU, Lawrence C, Fickenscher KA, Shao L, Lowe LH. Imaging of Pediatric Pelvic Neoplasms. Radiol Clin North Am 2011; 49:729-48, vi. [DOI: 10.1016/j.rcl.2011.05.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Iwasaki M, Taira K, Kobayashi H, Saiga T. Ovarian mucinous cystadenoma of borderline malignancy in a premenarchal girl. J Pediatr Adolesc Gynecol 2010; 23:e119-23. [PMID: 19896401 DOI: 10.1016/j.jpag.2009.09.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Revised: 09/21/2009] [Accepted: 09/22/2009] [Indexed: 10/20/2022]
Abstract
Ovarian mucinous cystadenomas are benign epithelial neoplasms that occur most often in the third to sixth decade of life. Ovarian mucinous cystadenoma can be classified into 3 categories (benign, borderline malignancy, malignancy) based on histopathologic evaluation. Premenarchal cases of ovarian mucinous cystadenoma of borderline malignancy are exceedingly rare. To the best of our knowledge, there have been only 4 reported cases of borderline ovarian mucinous cystadenoma prior to 2009. Here we report a 13-year-old premenarchal girl with a giant mass occupying almost the whole of the abdomino-pelvic cavity.
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Affiliation(s)
- Minoru Iwasaki
- Department of Pediatric Surgery, Otsu Red-Cross Hospital, Otsu City, Shiga 520-8511, Japan.
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A population-based analysis of 1037 malignant ovarian tumors in the pediatric population. J Surg Res 2009; 156:45-9. [PMID: 19592022 DOI: 10.1016/j.jss.2009.03.069] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 02/13/2009] [Accepted: 03/23/2009] [Indexed: 11/22/2022]
Abstract
BACKGROUND Concerns of malignant potential have impacted the utilization of ovarian salvage for treatment of ovarian masses in children. METHODS The Surveillance, Epidemiology, and End Results (SEER) registry was analyzed for all females < or =19 y diagnosed with an ovarian tumor between 1973 and 2005. RESULTS Overall, 1037 pediatric patients with ovarian tumors were identified. Approximately 61.7% of tumors occurred in patients 15 to 19 y old. The age-adjusted incidence of all malignant pediatric ovarian tumors in those < or =9 y was 0.102 versus 1.072 per 100,000 in those aged 10 to 19 y. The majority of cases (57.4%) present at an early localized stage. The predominant pathology was germ cell tumors in all age groups (77.4%). Overall 5- and 10-y survival rates are 91.7% and 91.4%, respectively. By multivariate analysis, advanced disease stage (HR 3.17, P<0.001), lack of surgery (HR 4.49, P =0.039), and poorly differentiated tumors (HR 3.40, P=0.011) were associated with worse outcomes. CONCLUSIONS Malignant ovarian tumors are rare, particularly in patients under 5 y of age. Furthermore, the most common histologies are of low metastatic potential and carry high cure rates. Thus, the surgeon should implement ovarian-sparing strategies on the affected ovary unless a malignancy is clearly suspected and conserve the contralateral ovary in all children.
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