Secondary ovarian neoplasms in children: imaging features with histopathologic correlation

Background. Although the pathologic features and imaging appearance of chil dhood primary ovarian neoplasms have been well described, little informatio n is available about the malignancies that may secondarily involve the ovar y. Objective. To determine the relationship between the imaging features and t he histopathology of secondary ovarian neoplasms in children treated at our institution. Materials and methods. We searched our institutional database for codes ind icating metastatic ovarian disease. Of the 35 patients with such codes, 18 had pathologically proven secondary ovarian disease. From their medical rec ords we recorded demographic data, presenting symptoms, and evidence, of en docrine dysfunction. We reviewed the pre-oophorectomy imaging and the subse quent pathologic specimens. Results. One-third of the patients had bilateral pelvic masses: another thi rd had large masses indistinguishable from the ovaries, Twelve (67 %) had e ither ascites, peritoneal implants, matted bowel, adenopathy, pleural effus ions. or some combination of these. Five (28 %) had other metastatic diseas e. Primary tumors included colon adenocarcinoma (9), Burkitt's lymphoma (3) , alveolar rhabdomyosarcoma (3), Wilms' tumor(l), neuroblastoma (1), and re tinoblastoma (1), Conclusion. Although rare, secondary ovarian tumors should be considered in the differential diagnosis of children with ovarian masses. Bilateral ovar ian masses or large masses indistinguishable from the ovaries. particularly in the presence of ether metastatic foci. may help distinguish primary fr arn secondary ovarian malignancies.