Pediatric Ovarian Tumors Video Podcast
With Dr. Fred Rescorla · hosted by Dr. Todd Ponsky · StayCurrentMD
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Predominantly cystic ovarian masses have approximately 3-4% risk of malignancy
Heterogeneous ovarian masses have approximately 15-20% malignancy risk
Solid ovarian masses have over 25% malignancy risk
Approximately 10% of pediatric ovarian tumors are malignant
Among malignant ovarian tumors in children, germ cell tumors comprise greater than 50% and in some series up to 80%
In benign ovarian tumors, mature teratoma represents at least half of cases
Immature teratoma comprises approximately 10-15% of benign ovarian tumors
For large predominantly cystic ovarian masses with normal markers, the risk of malignancy is much less than 1%
There is no oncologic requirement to remove the fallopian tube with malignant ovarian tumors if it can be preserved
CT scans are effective at detecting retroperitoneal lymph nodes and distant metastases in ovarian tumors
Peritoneal washings are the main finding that can upstage an otherwise stage 1 ovarian tumor
Pediatric surgeons deal primarily with germ cell tumors which are very chemo-responsive, while gynecologic surgeons deal more with epithelial tumors
For ovarian germ cell tumors, chemotherapy consists of platinum-based regimen with platinum, etoposide, and bleomycin
Stage 1 ovarian germ cell tumors have 96% overall survival
Stage 1 ovarian germ cell tumors managed without chemotherapy have approximately 50% relapse rate
The salvage rate for relapsed stage 1 ovarian germ cell tumors is nearly 100%
Approximately 50% of stage 1 ovarian germ cell tumor patients receive no chemotherapy at all
Stage 2 and 3 ovarian germ cell tumors have 97% survival with chemotherapy
Stage 4 ovarian germ cell tumors have approximately 80% overall survival
For stage 4 ovarian germ cell tumors, survival is approximately 92% if patient is less than 11 years of age
For stage 4 ovarian germ cell tumors, survival is approximately 60% if patient is over 11 years of age
Black, torsed ovaries should be detorsed and preserved rather than removed
Ovarian-preserving procedures should be performed for cystic or cystic with small solid component masses; only solid tumors require oophorectomy
In a study of stage 3 ovarian tumors with 20 patients, 5 were stage 3 only because peritoneal fluid was positive for malignant cells; without checking washings they would have been considered stage 1 with likely higher recurrence
A recent study in Fertility and Sterility Journal demonstrated that premenarchal girls have higher risk of ovarian torsion
The recommendation from the Fertility and Sterility study is to perform oophoropexy in premenarchal girls or if the same ovary has torsed before