Study Objective

Pediatric ovarian neoplasms with imaging appearance suggestive of teratoma are often presumed to have low risk of malignancy. We assessed the pre-operative imaging appearance of pediatric malignant ovarian germ cell tumors (MOGCT) and the presence of associated teratoma in a series of MOGCT.

Design

Retrospective review of clinical and pathology data.

Setting

Multicenter trial for extracranial malignant germ cell tumors in young female individuals by the Children's Oncology Group (COG study AGCT0132) that included yolk sac tumor, embryonal carcinoma and choriocarcinoma.

Participants

Female individuals 0-20 years of age at enrollment with ovarian primary nonseminomatous malignant germ cell tumors.

Interventions

Review of data forms, including prospectively collected surgical checklist documenting imaging characteristics of the tumor, and review of pathology reports.

Main Outcome Measures

Description of imaging appearance and frequency of mixed histology with benign teratoma elements.

Results

A total of 138 female individuals (11 months to 20 years of age) had primary ovarian tumors. Imaging appearance and pathology information were available for 133 patients. Among the 133 patients, tumor appearance was solid (10.5%), solid with calcification (3.0%), mixed cystic and solid (58.7%), mixed cystic and solid with calcification (24.8%), and unknown (3.0%). In all, 54% had elements of teratoma in addition to malignant histology.

Conclusion

Mixed cystic and solid appearance with or without calcification was seen in 83.5% of pediatric ovarian malignant germ cell tumors. Associated benign teratoma was common. The presence of a mixed cystic and solid appearance on preoperative imaging should not dissuade the surgeon from obtaining preoperative serum markers and undertaking complete surgical staging.

中文翻译：

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非生殖细胞瘤小儿卵巢生殖细胞肿瘤的影像学表现不能区分良性和恶性组织学

学习目标

影像学表现提示畸胎瘤的小儿卵巢肿瘤通常被认为具有较低的恶性肿瘤风险。我们在一系列 MOGCT 中评估了小儿恶性卵巢生殖细胞肿瘤 (MOGCT) 的术前影像学表现和相关畸胎瘤的存在。

设计

临床和病理学数据的回顾性审查。

环境

儿童肿瘤学组（COG 研究 AGCT0132）对年轻女性颅外恶性生殖细胞肿瘤的多中心试验，包括卵黄囊肿瘤、胚胎癌和绒毛膜癌。

参与者

入组时患有卵巢原发性非精原细胞恶性生殖细胞肿瘤的 0-20 岁女性个体。

干预措施

审查数据表格，包括前瞻性收集的记录肿瘤成像特征的手术清单，以及审查病理报告。

主要观察指标

具有良性畸胎瘤成分的混合组织学的成像外观和频率的描述。

结果

共有 138 名女性个体（11 个月至 20 岁）患有原发性卵巢肿瘤。133 名患者的影像学表现和病理信息可用。133例患者中，肿瘤外观为实性（10.5%）、实性伴钙化（3.0%）、囊实混合（58.7%）、囊实混合伴钙化（24.8%）、未知（3.0%）。总共有 54% 的患者除了恶性组织学外还有畸胎瘤。

结论

在 83.5% 的小儿卵巢恶性生殖细胞肿瘤中可见混合的囊实性外观，伴有或不伴有钙化。相关的良性畸胎瘤很常见。术前影像显示混合的囊性和实性外观不应阻止外科医生获取术前血清标志物并进行完整的手术分期。