Ovarian tumors in children

Ovarian tumors in children about the total number of children with cancer a ~ 1.6%, occurred in school-age children. increase with increased morbidity. Which accounts for about 30% of cancer around. (1) pathological classification of pediatric ovarian tumor classification many. WHO currently used ovarian tissue under the classification, Children under ovarian tumor characteristics accordingly modified. Ovarian tumors in children unilateral almost all cases, pathological type and adult different, germ cell tumors accounted for 80% more, germinal epithelial tumors rarely. (2) clinical performance : Children ovarian tumors often no symptoms, occasionally crash and the lower abdomen Shen Soul pain accompanied by nausea, stomach discomfort gastrointestinal symptoms, abdominal pain over the following mass treatment. If there stalk torsion can be dramatic colic; Tumor hemorrhage, or rupture of infection, acute peritonitis performance In severe cases, there may be shock. Malignant ovarian tumor growth rapidly, the children can have short-term loss of appetite, fatigue, weight loss and other symptoms for cachexia. It could lead to tumor suppression and defecation and urination difficulties, abdominal and lower extremity edema, ascites even there. (3) Diagnosis : Ovarian tumors in children due to pelvic smaller, relatively large tumor can often coming directly palpable abdominal mass. B-examination is still the first choice for the diagnosis can often clear the pelvic tumor location, size, texture; When suspected malignancy, and the invasion of adjacent organs when possible, CT, MRI and other tests to further clarify the tumor and adjacent organs, vascular important relationship. Determination of tumor markers of ovarian cancer in children have high diagnostic value of malignant teratoma, endodermal sinus tumor. embryonal tumors, such as malignant germ cell tumors often serum AFP was significantly increased; and granulosa cell tumor, germ cell tumor clones, theca tumors have estrogen and HCG abnormally high. Advanced cases of ascites cells smears, and other superficial inguinal lymph node biopsy. transabdominal uterine or rectal biopsy may sag clear cytological diagnosis. (4) Treatment : children ovarian cancer treatment is still a diagnosis of early surgical resection, in order to avoid reversed, rupture and malignant transformation. But children with ovarian cancer surgery principle involved gonadal function due to the maintenance and adults are different, Ovarian must consider the issue of reservations. Who should be retained benign ovarian side, even if both bilateral ovarian tumors, but also for tumor surgery. Sometimes it seems that only a few of ovarian tissue, can retain revascularization, despite ovulation, hormone secretion and maintain reproductive function. For the radical ovarian cancer, including the previous emphasis on bilateral ureteral ovarian, uterine, omentum and retroperitoneal lymph node dissection, chemotherapy drugs in recent years with updates and small residual lesions chemotherapy theory, advocate the contralateral not involved annex and uterine cancer, preserve the contralateral annex or uterus, but removing the omentum, and the right pelvic lymph node dissection, and other pelvic viscera removed to expand radical mastectomy that are currently considered to be excessive and unhelpful. And the initial failure to detect tumor resection, postoperative chemotherapy or radiotherapy and reduced tumor after radical CT and detection of tumor markers suggest a residual tumor, the second operation should be conducted to achieve radical purpose. Children majority of ovarian cancer to chemotherapy or radiotherapy are sensitive, germ cell tumors often chemotherapy and radiotherapy have a good response. Children in particular ovarian cancer often a higher degree of malignancy, that is, early disseminated, intraoperative rupture, abdominal cultivation, in the early postoperative chemotherapy. Advanced some cases and by chemotherapy or radiotherapy after radical extension or secondary create opportunities. Reproductive cells commonly used cancer chemotherapy of cisplatin, vinblastine Changchun new or alkaline pH, or bleomycin pingyangmycin, Time after chemotherapy to 1.5 ~ 2, it is advisable. (5) The prognosis : children ovarian tumor prognosis and tumor type, infiltration, pathological tissue differentiation and closely related to treatment outcome. Complete surgical resection of tumor were not generally recurrence, the prognosis is good. Tumors within endodermal sinus tumor cancer and embryo worst prognosis, the survival rate of malignant teratoma is a mere 40% and granulosa cell tumor, dysgerminoma the prognosis is relatively good. In recent years, with Cisplatin, VP-16 and other drugs in the application, after radiotherapy, Children ovarian cancer survival rates have improved significantly. Phase I patients survival rate was 100%, embryonic carcinoma, endodermal sinus tumor and malignant teratoma of the five-year survival rate is up to 26 ~ 39%, and III, IV children and relapses application preoperative chemotherapy and radiotherapy, with multiple abdominal radical and long-term survival of the clinical reports, Efficacy encouraging.