Prospective Observational Study of Ovarian Tumors Among Children in Tertiary Care Indian Teaching Hospital

Background Ovarian tumors although rare in childhood, malignant neoplasm are not uncommon. This aim of the study is to analyze the clinicopathological presentation of childhood ovarian tumors and its management in our institute. Methods In our prospective study from March 2005 to May 2014, 29 children with ovarian tumors were included. We collected the clinical, radiological, and pathological features of childhood ovarian tumors, and also assessed the treatment offered and clinical outcome. Results Study population of 29 patients represented neonates 27.58 % ( n = 8), infants 10.3 % ( n = 3), children of 2–10 years of age 27.58 % ( n = 8), and 11–15 years old 34.48 % ( n = 10). The commonest symptom at presentation was pain abdomen (41.38 %) followed by vomiting (27.58 %). Majority 62.07 % ( n = 18) of tumors were between 5 and 10 cm size. Antenatal imaging diagnosed the tumors in almost all neonates. The commonest image finding noted was a complex cyst 34.5 % ( n = 10). Right-sided tumors were 55.17 % ( n = 16) and remaining were left-sided tumors. Laparotomy was done in 68.97 % ( n = 20) children and remaining 31.03 % ( n = 9) underwent laparoscopic surgery. Oophorectomy alone was done in 62.07 % ( n = 18) children and complete staging with cytoreduction in 10.3 % ( n = 3). The commonest histopathology finding in neonates was hemorrhagic cyst 44.83 % ( n = 13). The malignant tumors 17.24 % ( n = 5) found were dysgerminoma, germ cell tumor, ovarian stromal tumor, and mixed germ cell tumor. Adjuvant chemotherapy was given in all malignant cases. In the median follow-up of 62 months (11–110 months), no child had recurrence. BEP was the most chemotherapy regimen used in GCT ovary. Conclusion Ovarian tumors are not uncommon in childhood. Hemorrhagic cyst was the most common ovarian pathology in neonates and most of them are identified on antenatal scans. Cystadenomas were the most common benign tumors. Unlike adults, although majority of pediatric ovarian tumors are benign at presentation, malignant ovarian tumors are not uncommon and constituted 17 % in our study. Germ cell tumors are common in childhood in contrast to epithelial tumors in adults. Minimal access surgery can be used in the management of benign tumors, if expertise is available. Malignant tumors are treated with adequate systematic staging and optimal cytoreductive surgery with combination of adjuvant chemotherapy. The prognosis is excellent with low recurrence rates, if the tumor