Abstract
The ovary is composed of epithelial, sex cord-stromal, and germ cell elements, each of which can produce neoplasms. Alpha-fetoprotein is normally secreted by embryonic and is elevated in patients with yolk sac (endodermal sinus) tumor and embryonal carcinoma. Beta-HCG is secreted by choriocarcinoma and embryonal carcinoma and can cause isosexual precocious puberty or menstrual disturbances. Non-echogenic simple cysts in newborns that are asymptomatic and less than 5 cm can be safely observed with serial pelvic ultrasound, with resolution expected within the first 3–6 months of life. In the setting of torsion, detorsion with ovarian preservation is preferred. Ultrasound is obtained in 2–3 months to exclude underlying pathology. If underlying neoplastic pathology is strongly suspected or if a large amount of necrotic tissue is present, oophorectomy is sometimes appropriate. Germ cell tumors make up nearly two thirds of ovarian masses in children, although sex cord-stromal tumors are relatively more common in young girls. Mature teratomas can often be excised with preservation of the ovary. Given the different tumor biology and the desire to preserve fertility in young girls, the operative approach to staging in children is more conservative than it is for adults. Tumors that arise from the surface epithelial cells are the least common ovarian neoplasm in children but are the predominant tumor type in adults.
Keywords
Ovarian tumor Choriocarcinoma Germ cell tumor Yolk sac tumor Alpha-fetoprotein Beta-HCG Oophorectomy Ovarian torsionSuggested Reading
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