Ovarian neoplasms in childhood and adolescence: I. Tumors of germ cell origin

Abstract

Abstract Seventy-five (40 per cent) of primary ovarian neoplasms in patients under 20 years of age were considered to be of non-germ cell origin. The majority of lesions in this group (53) arose from the coelomic epithelium or its derivatives and all were unilateral. Thirty-four of these were of serous cell type and 19 were of mucinous cell type; none were of endometrial cell type. Although the youngest patient of this group was 11 years of age, no patient was premenarchial. Four cystadenomatous lesions were considered histologically to have malignant areas; 2 patients are alive and well 6 years and 18 months after diagnosis; one patient died of metastatic disease after 13 months and the fourth patient had metastases at the time of diagnosis and although no survival information is available must be presumed dead. Eight neoplasms were of nonspecialized gonadal stromal origin; 3 benign fibromas, 3 supportive tissue sarcomas, and 2 lymphoblastomas that were histologically identical with lesions of so-called African lymphoma. Fourteen neoplasms were derived from specialized gonadal stromal elements; 3 were granulosa cell tumors, 3 were thecomas, 2 were mixtures of granulosa and theca cells, 3 were Sertoli cell tumors, and 3 were Sertoli-Leydig cell tumors (arrhenoblastomas). None of the granulosa-theca cell group of neoplasms occurred before puberty. One granulosa cell tumor behaved in a malignant manner, metastasizing and causing death. The 3 Sertoli cell neoplasms occurred in girls 3, 7, and 8 years of age, and 2 were associated with precocious development. The 3 arrhenoblastomas, occurring after puberty, produced masculinizing effects. None of the Sertoli-Leydig cell groups of neoplasms behaved in a malignant manner.