小儿及青春期卵巢肿瘤31例分析

An Analysis on 31 Cases of Ovarian Neoplasms in Children and Adolescents

目的 :分析小儿及青春期卵巢肿瘤的特征 ,探讨其诊断和治疗方法。方法 :回顾我院妇科 1999～ 2 0 0 3年 18岁以下幼少女卵巢肿瘤 31例。年龄 4～ 18岁 ,平均 14 .8岁。其中上皮性肿瘤 10例 ,生殖细胞肿瘤 15例 ,卵巢瘤样病变 6例。结果 :全部患者均经手术病理确诊 ,痊愈出院。 2例恶性生殖细胞肿瘤患者术后予化疗 ,随访至今。结论 :幼少女卵巢肿瘤大多为良性且生殖细胞肿瘤占多数 ,其组织类型在各年龄阶段分布不同。儿童及青春期卵巢肿瘤的诊断应注意其特点 ,减少误诊。除非证实肿瘤为恶性 ,否则应尽量保留卵巢 ,如对侧卵巢外观无异常 ,不应常规活检或楔形切除。卵巢恶性生殖细胞肿瘤可行保留生育功能的术式 ,除非对侧卵巢或子宫已经受累。PEB方案为术后化疗首选。

Objective: To analyze the characteristics, diagnoses and treatments of ovarian neoplasms in children and adolescents. Methods: 31 patients under 18 years old with ovarian neoplasms were diagnosed between 1999 to 2003. The age ranged from 4 to 18 years old with an average of 14.4 years. Ten of them with epithelial ovarian tumor,15 of them with ovarian germ cell tumor,6 of them with ovarian tumor like condition. Results: All the patients were treated by surgery and confirmed their diagnoses by pathology. All patients recovered satisfactorily. 2 patients with malignant ovarian germ cell tumor were treated with postoperative chemotherapy and further follow-up. Conclusion: Most of the tumors in children and adolescents are benign and germ cell tumor make the largest proportion to other histological types. The histological types of them varied in different periods. Characteristics should be paid more attention in order to decrease misdiagnosis. Ovary should be preserved unless malignancy is confirmed. Another ovary should not be opened if it looks normal. The conservative operation should be adopted to preserve fertility function in patients with malignant ovarian germ cell tumor unless the other ovary or uterus was involved. PEB is the first choice for postoperative chemotherapy.