Ovarian Tumor in Pediatrics and Adolescents: A Retrospective Clinicopathological Study in a Tertiary Care Hospital

Ovarian tumors in young patients

Abstract

Background: A small but significant portion of gynecological cancers in children and teenage girls is ovarian. They are responsible for 8% of all pediatric abdominal tumors and 1% of all pediatric cancers. These tumors were assumed to be uncommon in children since ovarian cysts are believed to develop from mature follicles.

Objectives: To determine the frequency, clinical features, radiological features and histological findings of various ovarian tumors in girls aged up to 19 years.

Methods: This retrospective study was done at Gynecological Oncology Department of BMU from 2016 to 2023 which included females aged 0–19 years who underwent surgery for ovarian masses with confirmed histopathology. Older patients (>19 years), incomplete records, missing imaging, and non-neoplastic lesions without histology were excluded. Data from medical records, imaging (USG/MRI) report, operation notes, and histopathology reports were abstracted, and tumors were classified as benign or malignant and by WHO histological category. According to age subjects were grouped as (0–9), (10–14), and 15–19 years. We estimated the proportion of pediatric/adolescent cases among all admissions at 95% CI and tested associations between tumor behavior and age group, presentation, size, laterality, and gross morphology. Malignant cases were staged by FIGO. Analyses used chi-square or Fisher’s exact tests for categorical data and t-test or Mann Whitney U for continuous data. P-value <0.05 was regarded as significant. IRB approval was obtained; consent was waived due to the retrospective design but strict confidentiality was maintained.

Result: Among 980 overian tumour, 63 were found in pediatric and adolescent age group. Among them 33 were benign and 30 were malignant. The majority of tumors occurred in the 15–19-year age group. Among benign tumors, mature cystic teratoma (45.5%) was the most common, while dysgerminoma (40%) predominated among malignant tumors. Clinically, benign cases mostly presented with abdominal pain (63.6%), while malignant cases more often presented with abdominal lump, acute abdomen, or ascites. Radiologically, benign tumors were typically smaller (<10 cm), unilateral, and unicystic, whereas malignant tumors were more often 10–15 cm, sometimes bilateral, and frequently cystic-solid.

Conclusion: Benign overian tumors slightly outnumbered malignant tumors. Mature cystic teratoma is the most
common benign tumor and dysgerminoma the leading malignancy. Benign cases usually had abdominal pain,
while malignant ones often presented with mass or acute abdomen.

Bangladesh Medical Res Counc Bull 2025;51(2): 55-62