What are ovarian tumors?

The ovary is one of a pair of female reproductive glands in females. Ovarian tumors make up approximately 1 percent of childhood cancer. Ovarian tumors seen in children and young adults are different from the tumors seen in older women. Among children, germ cell tumors are most common followed by stromal tumors. Epithelial ovarian tumors, the most common ovarian cancer in older women, are rare in pediatrics.

Germ cell tumors arise from the germ cells of the ovary. Stromal tumors arise from the supporting structures and cells of the ovary. Epithelial ovarian tumors arise from the covering or outer layer of the ovary.

What are symptoms of ovarian tumors?
Common symptoms that might be associated with ovarian tumors include abdominal pain, abdominal lump or changes in menstruation. Ovarian stromal tumors may include signs of unusual hormone production such as early puberty or signs of male hormone production such as excess hair, acne or voice changes.

Ovarian tumors may be seen sporadically (without any underlying process) or in the setting of specific genetic syndromes or cancer predisposition.

How are ovarian tumors diagnosed?
Evaluation for ovarian tumors starts with a thorough medical and family history, and physical examination. During the evaluation, the doctor looks carefully for any signs of early puberty or increased testosterone, thyroid nodules or skin or bone changes.

During the initial evaluation for suspected ovarian tumors, an ultrasound is commonly ordered. Depending on the results of the ultrasound, additional imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) scans might be needed.

Once an ovarian mass is detected, it is important to obtain blood tests for tumor markers, which include AFP and beta-HCG. Other blood tests for tumor markers such as LDH, inhibin A and B, mullerian inhibitory substance and CA125 may also be obtained.

How are ovarian tumors treated?
At Children’s of Minnesota, ovarian tumors are treated using a multidisciplinary team approach including pediatric experts from oncology, surgery and gynecology. Children’s has Minnesota’s only pediatric gynecologist. The surgical procedure chosen depends on the individual symptoms however most girls are eligible for fertility sparing surgery, or surgery that preserves the reproductive organs.

Children with stage I ovarian germ cell or stromal tumors are sometimes treated with surgery alone. Children with tumors that have ruptured or spread often require chemotherapy.

Careful attention is given to both potential short- and long-term side effects of therapy so that children have the best chance for normal fertility and a long and healthy life.

About treatment for ovarian tumors at Children’s Minnesota
Our cancer and blood disorders program consistently achieves excellent results ranking it in the top 10 programs in the United States. Children’s Minnesota treats the majority of children with cancer and blood disorders in Minnesota and provides patients access to a variety of clinical trials using ground-breaking new treatments. Through our renowned program, patients experience unparalleled family support, a nationally recognized pain management team, and compassionate, coordinated care.

Children’s also houses the International Ovarian and Testicular Stromal Tumor Registry that collects information about these rare tumors from all over the world. The registry collects clinical and biologic information to lead to improved treatment and screening for children with these rare tumors. If you or your child has been diagnosed with an ovarian tumor, contact your physician or the registry for more information regarding enrollment.

Contact us
If you are a family member looking for a Children’s oncologist, please call our clinic at 612-813-5940.

If you are a health professional looking for consultation or referral information, please call Children’s Physician Access at 1-866-755-2121 (toll-free) and ask for the on-call hematologist/oncologist.