Ovarian Carcinomas in Pediatric Age Group


Introduction:
Ovarian Carcinomas are unusual in pediatric age group. It accounts for only 1% of all tumors in girls below the age of 17 years. In the first differential diagnosis of ovarian tumors in adolescent girls, germ cell tumor comes first and carcinomas comes last.

Clinical Presentation:
Abdominal distension
Lower abdominal pain
Weight loss
Malaise

Signs:
Grossly underweight
Lower abdominal mass
ascites

Diagnosis:
Tumor markers
- CA 125
CA 125 - CA 125 serology has only 78.1 % sensitivity & 76.8 % specificity but it is useful in identifying recurrent or residual disease.
Ultrasonography- solid, cystic or mixed; arising from, areas of hemorrhage, liver metastasis, retroperitoneal lymph nodes.
CT scan- extent of tumor, exact origin of tumor, better delineation, lymph node status, peritoneal metastasis
Bone scan-for detection of metastasis.

Histopathology:
Serous
Mucinous
Undifferentiated

Treatment:
Surgery:
is done to confirm the diagnosis, stage the disease, & achieve tumor clearance in early stages & cytoreduction in late cases.
Chemotherapy: Cisplatin, cyclophosphamide, carboplatin, bleomycin, etoposide, & paclitaxel in various combinations.

Prognosis:
Stage of the disease
Histology

However the prognosis in premenarchal girls appears to be poor with no reported long term survivors.

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