Ovarian germ cell tumors are the most common neoplastic tumors of the ovary in children. Less common are tumors derived from the ovarian surface epithelium, accounting for 15% of ovarian neoplastic tumors. These epithelial tumors are rarely seen in premenarchal patients.
Ovarian epithelial tumors in children are either mucinous or serous. Each one of these two categories can be divided into a benign subgroup, malignant subgroup, or subgroup of tumors of low malignant potential, also known as borderline tumors (where the lack of invasion into the ovarian stroma is characteristic, despite varying levels of nuclear atypia). Thus a patient may have a mucinous cystadenoma, mucinous cystadenocarcinoma, or mucinous tumors of borderline malignancy.
The overall intraoperative management of this group of tumors is based on adult protocols. At minimum, thorough staging of the abdomen is required, with focus on careful examination of the contralateral ovary, as bilateral disease is common with these tumors.
Ovarian epithelial tumors in children are either mucinous or serous. Each one of these two categories can be divided into a benign subgroup, malignant subgroup, or subgroup of tumors of low malignant potential, also known as borderline tumors (where the lack of invasion into the ovarian stroma is characteristic, despite varying levels of nuclear atypia). Thus a patient may have a mucinous cystadenoma, mucinous cystadenocarcinoma, or mucinous tumors of borderline malignancy.
The overall intraoperative management of this group of tumors is based on adult protocols. At minimum, thorough staging of the abdomen is required, with focus on careful examination of the contralateral ovary, as bilateral disease is common with these tumors.
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