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Fuentes C, Ouldbey Y, Orbach D, Sudour-Bonnange H, Verité C, Rome A, Dumesnil C, Thebaud E, Hameury F, Dijoud F, Chabaud S, Cote MD, Fresneau B, Faure-Conter C. Oncological and endocrinological outcomes for children and adolescents with testicular and ovarian sex cord-stromal tumors. Results of the TGM13 National Registry. Pediatr Blood Cancer 2024; 71:e30864. [PMID: 38259036 DOI: 10.1002/pbc.30864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024]
Abstract
RATIONALE Sex cord-stromal tumors (SCST) are hormonally active and rare. The aim was to describe their endocrinological presentation and outcomes. METHOD Patients (< 19 years) registered in the TGM13 registry between 2014 and 2021 for SCST were selected. RESULTS Sixty-three ovarian SCST (juvenile granulosa tumor (JGT) n = 34, Sertoli-Leydig cell tumor (SLCT) n = 17, other SCST n = 12) were included. Median age was 13.1 years (0.4-17.4). Germline DICER1 pathogenic variant was present in 9/17 SLCT. Sixty-one were FIGO stage I (IC n = 14). Adjuvant chemotherapy was administered for 15. Seven had recurrence (FIGO IA n = 3, IX n = 2, III n = 2), leading to one death. With a median follow-up of 42 months (2.5-92), the 3-year progression-free survival (PFS) was 89% (95% CI 76%-95%). Median age was 6.4 years (0.1-12.9) among the 15 testicular SCST (Leydig cell tumor n = 6, JGT n = 5, Sertoli cell tumor n = 3, mixed SCST n = 1). Tumor-nodes-metastases (TNM) stage was pSI in 14. Eight underwent a tumorectomy, 7 an orchiectomy. None experienced recurrence. Endocrinological data were reviewed for 41 patients (18 prepubescent). Endocrine symptoms were present at diagnosis in 29/34 females and 2/7 males (gynecomastia). After a median follow-up of 11 months, 15 patients had persistent endocrine abnormalities: gynecomastia/breast growth (2 males, 1 prepubescent female), precocious/advanced puberty (4 prepubescent females), and hirsutism/menstruation disorders/voice hoarseness/hot flashes (8 pubescent females). The mean height at the last follow-up was within normal ranges (+0.3 standard deviation). CONCLUSIONS SCSTs have a favorable prognosis. Tumorectomy appears safe with testicular primary. Endocrinological disorders, common at diagnosis, may persist warranting endocrinological follow-up.
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Affiliation(s)
- Clemence Fuentes
- Department of Pediatric Oncology, Institut d'Hemato-oncologie Pediatrique, Lyon, France
| | - Yaelle Ouldbey
- Statistical Unit, Clinical Research Department, Centre Léon Bérard, Lyon, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer) Institut Curie, PSL University, Paris, France
| | - Helene Sudour-Bonnange
- Anti-Cancer Center Oscar Lambret, Pediatric and Adolescents Oncology Unit, Lille, France
| | - Cecile Verité
- Pediatric Hematology-Oncology Unit, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Angelique Rome
- Department of Pediatric Oncology of Timone Children's Hospital, Marseille, France
| | - Cecile Dumesnil
- Department of Pediatric Oncology, University Hospital Center of Rouen, Rouen, France
| | - Estelle Thebaud
- Department of Pediatric Oncology, University Hospital Center of Nantes, Nantes, France
| | - Frederic Hameury
- Department of Pediatric Surgery, Hôpital Femme Mère Enfant, Lyon, France
| | | | - Sylvie Chabaud
- Statistical Unit, Clinical Research Department, Centre Léon Bérard, Lyon, France
| | - M Daval Cote
- Département of Endocrinology and Pediatric Diabetology, Hospices civils de Lyon, Lyon, France
| | - Brice Fresneau
- Gustave Roussy, Université Paris-Saclay, Department of Children and Adolescent Oncology, Paris-Saclay University, Paris-Sud University, CESP, INSERM, Villejuif, France
| | - Cecile Faure-Conter
- Department of Pediatric Oncology, Institut d'Hemato-oncologie Pediatrique, Lyon, France
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Eoh KJ, Park J, Kim HM, Lee M, Kim YT. Comparison of the Prognostic Outcome between High-Grade Ovarian Sertoli-Leydig Cell Tumors (SLCTs) and Low-Grade SLCTs. Yonsei Med J 2021; 62:366-369. [PMID: 33779091 PMCID: PMC8007424 DOI: 10.3349/ymj.2021.62.4.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/02/2020] [Accepted: 01/05/2021] [Indexed: 11/27/2022] Open
Abstract
The purpose of the current study was to compare prognostic outcomes between patients with high-grade ovarian Sertoli-Leydig cell tumors (SLCTs) and those with other low-grade SLCTs. We retrospectively reviewed medical records for 24 patients pathologically diagnosed with SLCTs between 2006 to 2019 at two institutions. The patients were grouped according to pathological grade: SLCT was classified as grade 1, well differentiated; grade 2, intermediated differentiated; or grade 3, poorly differentiated (Meyer's classification). Statistical analysis was performed to compare survival outcomes according to pathological grade. The median patient age was 42.5 years (range 16-75). Eighteen patients (75%) were International Federation of Gynecology and Obstetrics stage I, and none were diagnosed in stage IV. Nine patients (37.5%) were grade 3, and 15 patients (63.5%) were grades 1-2. When comparing clinical baseline characteristics of the grade 1-2 group with those of the grade 3 group, only serum CA125 level at diagnosis was significantly higher in the grade 3 group (38.34 vs. 382.29, p=0.002). Five patients experienced recurrence of grade 3 disease, while no recurrence was reported in grade 1-2 disease. Four of the five recurrent patients died. In result, grade 3 ovarian SLCT showed significantly poorer prognosis than grade 1-2 disease (overall survival, hazard ratio=14.25, 95% confidence interval=1.881-108.0; log-rank p=0.010). Our findings were consistent with the concept that patients with stage I/grade 1-2 tumors have a good prognosis without adjuvant chemotherapy. Since grade 3 ovarian SLCT appears to be relatively more fatal than grade 1 or 2, patients with grade 3 SLCT might require more aggressive surgical intervention and post-treatment surveillance.
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Affiliation(s)
- Kyung Jin Eoh
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Korea
| | - Junsik Park
- Department of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
| | - Hye Min Kim
- Department of Pathology, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Korea
| | - Maria Lee
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| | - Young Tae Kim
- Department of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea.
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Abstract
From 1962 to 1976, 15 children up to the age of 15 years with malignant neoplasms of the ovary were observed at the Istituto Nazionale Tumori of Milan. 13 patients had a germ cell tumor and 2 a stromal tumor. Natural history and treatment results are reported. Out of 7 patients with dysgerminoma, 3 at stage IA, 2 at stage III retroperitoneal and 1 with recurrent disease are alive and disease free 38+, 20+, 36+, 16+, 23+, 156+ months after the histologic diagnosis; the last case with stage III peritoneal disease died 2 months after the diagnosis. Four children had immature malignant teratoma: 2 patients are alive and disease free 19+ and 51+ months, 1 is alive with disease 20+ months and 1 died 16 months after histologic diagnosis. Two patients with extra-embryonal teratoma died 7 and 12 months after diagnosis. One patient, treated by surgery plus chemotherapy for granulosa cell tumor at stage III, is alive 43+ months later. The child with arrhenoblastoma at stage III treated by surgery plus radiochemotherapy died 6 months after diagnosis. Through a close scrutiny of the literature and by drawing on experience gained in the treatment of the same tumors in adults, a rational approach to the diagnosis and treatment of each childhood ovarian tumor histotype is worked out.
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Gavrilescu C, Cernea M, Stratulat S. [Arrhenoblastoma of the ovary. Presentation of a case]. Rev Med Chir Soc Med Nat Iasi 1977; 81:321-3. [PMID: 198864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Giugiaro A, Canavese F. [Tumors of the ovary in childhood]. Minerva Pediatr 1975; 27:2149-82. [PMID: 172771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Bailey RR. Arrhenoblastoma: case report. N Z Med J 1969; 69:230-1. [PMID: 4307838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Mironova OG. [Malignant bilateral ovarian arrhenoblastoma]. Akush Ginekol (Mosk) 1968; 44:63-4. [PMID: 4333346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Chomette G, Monsaingeon A, Brocheriou C, Auriol M, Pinaudeau Y. [Testicular feminization and androblastoma]. Arch Anat Pathol (Paris) 1968; 16:48-51. [PMID: 4315393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Bologna A, Billia P, Gallinaro P. [Considerations on ovarian tumors with endocrine activity. On the subject of neoplasms of the female genital system]. MINERVA CHIR 1967; 22:1333-43. [PMID: 4295724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Lammes FB, Haak A. [Demonstration of a patient with an adrenal cell tumor of the ovary]. Ned Tijdschr Verloskd Gynaecol 1967; 67:510-3. [PMID: 4295351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Lammes FB, Haak A. [Demonstration of a patient with an ovarian adrenal cell tumor]. Ned Tijdschr Geneeskd 1967; 111:1989-90. [PMID: 4294295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Shamis AA. [On the problem of arrhenoblastoma of the ovary]. Akush Ginekol (Mosk) 1967; 43:58-9. [PMID: 4308110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Felmus LB, Pedowitz P. Clinical malignancy of endocrine tumors of the ovary and dysgerminoma. Obstet Gynecol 1967; 29:344-50. [PMID: 4289598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Santoscoy GS, Welch JS. Tumors of urinary tract origin in the female pelvis. Clin Obstet Gynecol 1967; 10:202-16. [PMID: 4289937 DOI: 10.1097/00003081-196703000-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Abell MR. Ovarian neoplasms in childhood and adolescence. J Ark Med Soc 1967; 63:279-85. [PMID: 4292516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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de Lima GR, Netto CDG, Franca LC, Altenfelder A. Arrhenoblastoma of the right ovary. Report of a case. Obstet Gynecol 1966; 27:107-9. [PMID: 4285025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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OKUN LE. BILATERAL ARRHENOBLASTOMA OF THE OVARY; REPORT OF A CASE. Obstet Gynecol 1965; 25:448-50. [PMID: 14268029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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de Lima GR, Netto CDG, França LC, Silva AA. [Arrhenoblastoma of the ovary. (Presentation of a case)]. Matern Infanc (Sao Paulo) 1965; 24:226-38. [PMID: 4284704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Gafà L, Buscemi C. [Specific mesenchymomas of the female gonads in childhood]. Arch De Vecchi Anat Patol 1965; 45:165-207. [PMID: 4287105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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ROSNER JM, CONTE NF, BRIGGS JH, CHAO PY, SUDMAN EM, FORSHAM PH. DETERMINATION OF URINARY TESTOSTERONE BY CHROMATOGRAPHY AND COLORIMETRY: FINDINGS IN NORMAL SUBJECTS AND IN PATIENTS WITH ENDOCRINE DISEASES. J Clin Endocrinol Metab 1965; 25:95-100. [PMID: 14252291 DOI: 10.1210/jcem-25-1-95] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Gomeniuk IP, Gitel'man EV. [A case of arrhenoblastoma of the ovary]. Pediatr Akus Ginekol 1965; 1:48. [PMID: 4294696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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CARTER WF. PRIMARY OVARIAN MALIGNANCY. REVIEW OF ONE HUNDRED CASES AT TWO HOSPITALS. Am J Obstet Gynecol 1964; 90:651-6. [PMID: 14241504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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DOUGHERTY CM, COTTEN NM. PROLIFERATIVE EPITHELIAL LESIONS OF THE UTERINE TUBE. I. ADENOMATOUS HYPERPLASIA. Obstet Gynecol 1964; 24:849-54. [PMID: 14244864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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GOLDZIEHER JW. THE HIRSUTE FEMALE: OVARIAN DYSFUNCTION. Clin Obstet Gynecol 1964; 10:1160-80. [PMID: 14234042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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