Clinical characteristic of girls with ovarian teratomas

Abstract

Actuality: Teratoma is a group of germ cell tumors, developing from pluripotent embryonic gonadae cells capable to undergo somatic and trophoblastic differentiation and histogenetically be a source of various tumors. Teratoma may be localized primarily in the ovaries. While scrutinizing available literature, we found no data on clinical characteristic of adolescents with this pathology. Objective: To provide clinical and anamnestic analysis of patients and undertake structural and morphological analysis of ovarian teratomas based on medical records of adolescent girls admitted to The Research Center for Obstetrics, Gynecology and Perinatology in 2015. Materials and methods: patients from 7 to 17 years old with ovarian teratomas. A retrospective study using clinical-anamnestic, laboratory, and instrumental methods of research. Results: In 2015, 61 patients with ovarian tumors were surgically treated. Of these, 42.6% had ovarian teratoma. There were 3 immature teratomas with malignant component, and 23 patients – mature tumors. The average age of girls was 12.8 ± 0.7 years. 9 (17.0%) patients were asymptomatic. However, the majority (66.7%) complained of periodic pelvic pain, lower back (5.9%), menstruation desorders (35%). According to medical records in one case severe preeclampsia was reported during mother's pregnancy, and twice – neonatal pathology (acute hypoxia, prematurity). 18 girls had average age of menarche 12.8 ± 0.7 years and 9 patients (33.3%) were prepubertal. In 8 (66.6%) of menstruating girls menstrual cycle disorders like delay up to 60 days were observed. According to pelvic ultrasound examination in all cases signs of teratomas were observed. Three girls had teratoma associated with PCOS, four had gidatids, two -malformations of uterus. At gynecological examination teratomas appeared as sensitive tight-elastic masses. Blood tests for tumor markers showed a 2.5-fold increase of CA-125 in two girls with immature ovarian teratomas. In 22 patients the removal of teratoma by ovarian resection preserving healthy tissue was performed during laparoscopy. Three patients underwent laparotomy because of gigant size of tumor and/or malignancy. Postoperative period was uneventful. The results of the histological study showed that teratomas consisted of skin and its appendages (27%), glia with neurons (26%), cartilage (10%), less adipose tissue (6%), tooth tissue, the epithelium of the intestinal and respiratory tract (3%) Conclusion: Perhaps the study of ovarian reserve in these patients will mark the prognosis of fertility in the future.