The role of tumor markers in the surgical approach of ovarian masses in pediatric age: a 10-year study and a literature review.

Abstract

The purpose of this study was to detect the role of serum tumor markers in the differential diagnosis and in the choice of the surgical treatment of ovarian lesions in pediatric age. We retrospectively reviewed medical charts of all pediatric girls operated in two pediatric centers during a 10-year period. The following features were analyzed: age at the moment of presentation, symptoms, diagnostic studies, surgical approach, pathological findings, and, in particular, serum tumor markers. Also, a literature review and statistical analysis (χ(2) test) concerning the increase of different tumor markers in benign and malignant ovarian lesions were related to the study. A total of 120 children with 127 ovarian masses (7 with bilateral pathologies) were reviewed. Pathology showed 61 nonneoplastic lesions (48%), 54 benign tumors (42.5%), 5 malignant tumors (4%), and 7 torsed normal ovaries (5.5%). The evaluation of serum tumor markers was performed in 106 cases and was positive in 16 (15.1%): in all of the 5 cases (100%) of malignant neoplastic lesions and in 11 (20.4%) benign neoplastic ones. The literature review confirmed these data, and statistical analysis highlighted them as significant values. The role of tumor markers is still controversial. This is the reason why, before considering a radical treatment, we suggest caution to optimize future fertility.