Diagnosis, pathology, staging, treatment, and outcome of epithelial ovarian neoplasia in patients age < 21 years Journal Article

Authors: Tsai, J. Y.; Saigo, P. E.; Brown, C.; La Quaglia, M. P.
Article Title: Diagnosis, pathology, staging, treatment, and outcome of epithelial ovarian neoplasia in patients age < 21 years
Abstract: BACKGROUND. Epithelial ovarian neoplasms are rare in patients under the age of 21 years. This is a report of a series of such patients documenting their presentation, histologic type, stage of disease, treatment, and outcome. METHODS. Clinical findings, histology, stage, treatment, and outcomes of 19 patients with epithelial ovarian neoplasia are reported. All histology was rereviewed. RESULTS. The median age at the time of diagnosis was 19.7 years (range, 14.1-21.8 years), and the median follow-up was 5.6 years (range, 0.2-19.5 years). The most common presenting symptom was dysmenorrhea (100%) followed by abdominal pain (68%), and the initial diagnosis usually was made ultrasonographically. There were nine (47%) serous tumors, 7 (37%) mucinous tumors, 2 (11%) small cell carcinomas, and 1 (5%) endometrioid carcinoma. Seventy-nine percent of tumors were unilateral, and 84% were low malignant potential or well differentiated tumors. Surgical treatment included unilateral salpingo-oophorectomy in 12 patients (63%), total abdominal hysterectomy and bilateral salpingo-oophorectomy in 6 patients (32%), and ovarian cystectomy in 1 patient (5%). Fifteen patients (79%) had Stage I disease, and 4 patients (21%) had Stage III disease at the time of diagnosis. There were two deaths in this series, and both occurred in patients with small cell anaplastic carcinoma. CONCLUSIONS. Epithelial ovarian neoplasias are rare in patients in this age group but must be included in the differential diagnosis of an ovarian mass. Most patients present with Stage I tumors of low malignant potential. In these patients, good survival is achieved with unilateral salpingo-oophorectomy and preservation of fertility. In contrast, small cell carcinomas are very. aggressive, and patients with this variant require intensive therapy. © 2001 American Cancer Society.
Keywords: adolescent; adult; clinical article; controlled study; human tissue; treatment outcome; retrospective studies; clinical feature; histopathology; treatment; cancer staging; follow up; staging; cancer diagnosis; endometrioid carcinoma; neoplasm staging; salpingooophorectomy; ovarian neoplasms; diagnosis, differential; ovariectomy; histology; age; abdominal pain; ovary; ovary tumor; echography; cystectomy; carcinoma; childhood; age of onset; epithelium tumor; abdominal hysterectomy; female fertility; mucinous carcinoma; small cell carcinoma; fallopian tubes; neoplasms, glandular and epithelial; adolescence; international federation of gynecology and obstetrics; dysmenorrhea; humans; prognosis; human; female; priority journal; article
Journal Title: Cancer
Volume: 91
Issue: 11
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2001-06-01
Start Page: 2065
End Page: 2070
Language: English
DOI: 10.1002/1097-0142(20010601)91:11<2065::aid-cncr1233>3.0.co;2-r
PUBMED: 11391586
PROVIDER: scopus
Notes: Export Date: 21 May 2015 -- Source: Scopus
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MSK Authors
  1. Carol Brown
    121 Brown
  2. Patricia E Saigo
    52 Saigo