GYNECOLOGIC TUMORS AND SYMPTOMS IN CHILDHOOD AND ADOLESCENCE - 10-YEARS EXPERIENCE

OBJECTIVES. The advancement of diagnostic imaging evaluations and the earlier occurrence of secondary sexual development prompted us to revi ew our recent experience with genital tract tumors in children. METHOD S. We analyzed data for 1938 patients aged less than 18 years who were referred to Gifu University School of Medicine-affiliated Hospitals f or the years 1984 through 1993. RESULTS: Of the patients, 145 underwen t surgical treatment. Vaginal tumor was seen in 5 patients; 1 endoderm al sinus tumor, 1 sarcoma botryoides and 3 Gartner's duct cysts. Two p atients with malignant tumor presented only with bloody vaginal discha rge; recurrent abdominal pain due to vaginal obstruction was noted in 1 patient with the cyst. Ten had benign tumors in the vulva, presentin g with a genital mass. Of 114 ovarian tumors, 3 were diagnosed by ante natal ultrasonographic examinations. Fifty-five had germ cell tumors, 33 had epithelial tumors, and 18 had stromal tumors. The most common s ymptom was abdominal pain and approximately one-third of girls who com plained of abdominal pain had an ovarian tumor. Precocious puberty was noted in 4 girls with stromal tumor. Two of the 23 malignant tumors d eveloped in the vagina and the others originated in the ovary. In 19 p atients unilateral salpingo-oophorectomy or local excision was done in an attempt for reproductive organ conservation, 4 cases of advanced s tage disease were treated with hysterectomy and/or bilateral salpingo- oophorectomy. Only 3 of the 23 patients with malignant tumor died with in 4 years and others are free from disease. CONCLUSIONS. Genital symp toms, even common, alert us to the posibility of a genital tract tumor . The prompt and precise detection of either benign or malignant tumor s in children may lead to cure and preservation of fertility with cons ervative surgery.