| Institution: | 1. Service de radiologie pédiatrique, hôpital Bicêtre, AP–HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France;2. Inserm, Santé publique et épidémiologie, hôpital Bicêtre, AP–HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France;3. Service d’imagerie médicale, Institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif, France;4. Service de chirurgie pédiatrique, hôpital Bicêtre, AP–HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France;5. Faculté de médecine Paris Sud, Paris, France |
| Abstract: | ObjectivePictorial review with a detailed semiological analysis of ovarian tumors in children and adolescents to provide a relevant diagnostic approach.Patients and methodsRetrospective study (2001–2011) of 41 patients under the age of 15 who underwent surgery for an ovarian mass with a definite pathological diagnosis.ResultsSixty-two percent of the lesions were benign, 33% were malignant and 5% were borderline. Germ cell tumors were most frequent (77.5%), followed by sex cord stromal tumors (12.5%) and epithelial tumors (7.5%). Malignant tumors were more frequent in children between 0 and 2 years old. On imaging, calcifications and fat were specific for germ cell tumors; the presence of a mural nodule was predictive of a mature teratoma (P < 0.001). Predictive factors for malignancy were clinical, including abdominal distension (P < 0.01) or a palpable mass (P = 0.05), biological, including increased hCG and/or AFP levels (P < 0.001) and radiological, including tumors larger than 12 cm (P < 0.05), tumoral hypervascularity (P < 0.01) and voluminous ascites (P < 0.01).ConclusionThis semiological analysis confirms the role of imaging in diagnosing the etiology of ovarian lesions in children and adolescents and emphasizes the importance identifying tumoral hypervascularity, which, in addition to classic criteria, is highly predictive of malignancy. |
