Pediatric ovarian neoplastic tumors: incidence, age at presentation, tumor markers and outcome

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Abstract
Objective: To investigate the incidence, age of onset and tumor marker levels in benign and malignant pediatric ovarian neoplastic tumors.Design: Retrospective database study.Setting: Single‐center study.Population: Forty‐five 0–15‐year‐old girls operated on for ovarian neoplastic tumors from the beginning of 1999 to the end of 2013.Methods: Serum alpha‐fetoprotein, human chorionic gonadotropin and CA 125 levels as well as follow‐up data were recorded from patient charts and tumor histology was re‐evaluated.Main outcome measures: Incidence of ovarian neoplastic tumors in the pediatric population. Differences in patient characteristics and tumor marker levels between those with benign and malignant tumors.Results: The annual incidence of ovarian tumors was 2.2/100 000 females. Median age at presentation was 13.0 years (range 0.9–15.7), similar in both the 33 (73%) girls with a benign tumor and the 12 (27%) girls with a malignant tumor. The tumors with the highest propensity to metastasize (yolk sac tumors, mixed germ cell tumors, small cell carcinoma) were only found in girls > 9 years. Elevated serum alpha‐fetoprotein and CA 125 values associated more often with malignant tumors (p < 0.001 and p < 0.031, respectively). There were no deaths or local recurrences. Four girls with a mature teratoma developed a contralateral benign ovarian tumor during follow up.Conclusions: Both benign and malignant ovarian tumors are rare in the pediatric population, but the incidence increases with age. High alpha‐fetoprotein and CA 125 levels were associated with malignant tumors. The prognosis of the pediatric ovarian tumors seems to be favorable.

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