Adolescent Ovarian Tumors: A Clinical Analysis Of 128 Cases

Objective: To study the clinical characteristics of incidence, diagnosis, treatment and therapy of adolescent ovarian tumors.Methods: Make a retrospective study of 128 cases aged from 10 to 19 with ovarian tumors in our department between January 1999 and December 2008.Results: The rate of adolescent ovarian tumors in contemporaneous ovarian tumors is 5.3%. There are 114 cases of benign tumors , 2 cases of borderline tumors and 12 cases of malignancy tumors(5.6% in contemporaneous malignancy ovarian tumors). The MOGCT rats 58.3%(7/12). Germ cell tumors occupied 47 cases (36.7%), tumour-like lesion 40 cases (31.3%), epithelial tumors 37cases (28.9%) and sex cord stromal tumors 3 cases (2.3%), lipid-like cell tumor 1 case (0.8%) respectively. Abdominalgia, abdominal distention, menoxenia and the mass in the pelvic and lower abdominal cavity were the most common symptoms. The rate of misdiagnosis of adolescent ovarian tumors was 29.7%.The ultrasound check has high accuracy rate in diagnosis of tumors. The highest rate is cystic teratoma 77.5% (31/40), next is rhexis of tumor 61.1% (11/18) and torsion of pedicle 58.6% (17/29). The sonographic features is useful to judge if the tumor is benign or malignancy. The check rate of tumor markers in serum is 10.9%. Only 7 cases took the check of the cast-off cells in ascites. The frozen section was taken in 20.3% of patients,and the accurate rate to the final result was 76.9%. The error rate of the nature of the tumors was 15.4%. The fertility-sparing therapy was warranted in the benign and early malignant cases. The torsion always resulted in the loss of unilateral ovarian and Fallopian tube. The laparoscope was taken 28 cases (24.6%), it made the time in hospital declined. Chemotheray was used in 6 cases of all 12 malignant cases,and the course of treatment were not canonical.Conclusions: We suggest that girls should obtain a complete examination including the pelvic organ who are in 1-2 years after menarche or 16 years old premenarche.clinical doctors should pay attention to the chief complaint, menses and the symptoms and sign associated with pelvic and abdominal organ, and try to reduce the misdiagnosis and incorrect treatment.The ultrasound check has high accuracy rate in diagnosis of tumors.The making scheme and blood flow system should be carry out. Must pay attention to the check of tumor markers in serum ,for its'effort in pre-operation, treating and follow-up procedure.And we suggest CA125 should be the routine item. The error rate of the frozen section in the nature of the tumors is high. We should evaluate it synthetically. Check of the cast-off cells in ascites also calls to be pay attention to. The fertility-sparing therapy was warranted in the benign and early malignant cases.The laparoscope should be taken in more benign tumors for its good. Chemotheray is important to be pay close attention to. And the follow-up job must be strengthen.