Deborah Billmire1, Bryan Dicken2, Frederick Rescorla3, Jonathan Ross4, Jin Piao5, Li Huang5, Mark Krailo6, Farzana Pashankar7, Lindsay Frazier8. 1. Division of Pediatric Surgery, Indiana University, Indianapolis, Indiana. Electronic address: dbillmir@iupui.edu. 2. Division of Pediatric Surgery, University of Alberta, Edmonton, Alberta, Canada. 3. Division of Pediatric Surgery, Indiana University, Indianapolis, Indiana. 4. Department of Urology, Rush University, Chicago, Illinois. 5. Children's Oncology Group, Monrovia, California. 6. Department of Research Preventive Medicine, University of Southern California, Monrovia, California. 7. Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut. 8. Department of Pediatrics, Harvard University, Dana Farber Cancer Institute, Boston, Massachusetts.
Abstract
STUDY OBJECTIVE: Pediatric ovarian neoplasms with imaging appearance suggestive of teratoma are often presumed to have low risk of malignancy. We assessed the pre-operative imaging appearance of pediatric malignant ovarian germ cell tumors (MOGCT) and the presence of associated teratoma in a series of MOGCT. DESIGN: Retrospective review of clinical and pathology data. SETTING: Multicenter trial for extracranial malignant germ cell tumors in young female individuals by the Children's Oncology Group (COG study AGCT0132) that included yolk sac tumor, embryonal carcinoma and choriocarcinoma. PARTICIPANTS: Female individuals 0-20 years of age at enrollment with ovarian primary nonseminomatous malignant germ cell tumors. INTERVENTIONS: Review of data forms, including prospectively collected surgical checklist documenting imaging characteristics of the tumor, and review of pathology reports. MAIN OUTCOME MEASURES: Description of imaging appearance and frequency of mixed histology with benign teratoma elements. RESULTS: A total of 138 female individuals (11 months to 20 years of age) had primary ovarian tumors. Imaging appearance and pathology information were available for 133 patients. Among the 133 patients, tumor appearance was solid (10.5%), solid with calcification (3.0%), mixed cystic and solid (58.7%), mixed cystic and solid with calcification (24.8%), and unknown (3.0%). In all, 54% had elements of teratoma in addition to malignant histology. CONCLUSION: Mixed cystic and solid appearance with or without calcification was seen in 83.5% of pediatric ovarian malignant germ cell tumors. Associated benign teratoma was common. The presence of a mixed cystic and solid appearance on preoperative imaging should not dissuade the surgeon from obtaining preoperative serum markers and undertaking complete surgical staging.
STUDY OBJECTIVE: Pediatric ovarian neoplasms with imaging appearance suggestive of teratoma are often presumed to have low risk of malignancy. We assessed the pre-operative imaging appearance of pediatric malignant ovarian germ cell tumors (MOGCT) and the presence of associated teratoma in a series of MOGCT. DESIGN: Retrospective review of clinical and pathology data. SETTING: Multicenter trial for extracranial malignant germ cell tumors in young female individuals by the Children's Oncology Group (COG study AGCT0132) that included yolk sac tumor, embryonal carcinoma and choriocarcinoma. PARTICIPANTS: Female individuals 0-20 years of age at enrollment with ovarian primary nonseminomatous malignant germ cell tumors. INTERVENTIONS: Review of data forms, including prospectively collected surgical checklist documenting imaging characteristics of the tumor, and review of pathology reports. MAIN OUTCOME MEASURES: Description of imaging appearance and frequency of mixed histology with benign teratoma elements. RESULTS: A total of 138 female individuals (11 months to 20 years of age) had primary ovarian tumors. Imaging appearance and pathology information were available for 133 patients. Among the 133 patients, tumor appearance was solid (10.5%), solid with calcification (3.0%), mixed cystic and solid (58.7%), mixed cystic and solid with calcification (24.8%), and unknown (3.0%). In all, 54% had elements of teratoma in addition to malignant histology. CONCLUSION: Mixed cystic and solid appearance with or without calcification was seen in 83.5% of pediatric ovarian malignant germ cell tumors. Associated benign teratoma was common. The presence of a mixed cystic and solid appearance on preoperative imaging should not dissuade the surgeon from obtaining preoperative serum markers and undertaking complete surgical staging.
Authors: Frederick J Rescorla; Jonathan H Ross; Deborah F Billmire; Bryan J Dicken; Doojduen Villaluna; Mary M Davis; Mark Krailo; John W Cullen; Thomas A Olson; Rachel A Egler; James F Amatruda; Carlos Rodrigues-Galindo; A Lindsey Frazier Journal: J Pediatr Surg Date: 2015-03-14 Impact factor: 2.545
Authors: Furqan Shaikh; John W Cullen; Thomas A Olson; Farzana Pashankar; Marcio H Malogolowkin; James F Amatruda; Doojduen Villaluna; Mark Krailo; Deborah F Billmire; Frederick J Rescorla; Rachel A Egler; Bryan J Dicken; Jonathan H Ross; Marc Schlatter; Carlos Rodriguez-Galindo; A Lindsay Frazier Journal: J Clin Oncol Date: 2017-02-27 Impact factor: 44.544
Authors: Deborah F Billmire; John W Cullen; Frederick J Rescorla; Mary Davis; Marc G Schlatter; Thomas A Olson; Marcio H Malogolowkin; Farzana Pashankar; Doojduen Villaluna; Mark Krailo; Rachel A Egler; Carlos Rodriguez-Galindo; A Lindsay Frazier Journal: J Clin Oncol Date: 2014-01-06 Impact factor: 44.544
Authors: Jonathan C Papic; S Maria E Finnell; James E Slaven; Deborah F Billmire; Frederick J Rescorla; Charles M Leys Journal: J Pediatr Surg Date: 2013-11-22 Impact factor: 2.545
Authors: Arin L Madenci; Bat-Sheva Levine; Marc R Laufer; Theonia K Boyd; Stephen D Voss; David Zurakowski; A Lindsay Frazier; Christopher B Weldon Journal: J Pediatr Surg Date: 2016-05-31 Impact factor: 2.545
Authors: Amy E Lawrence; Mary E Fallat; Geri Hewitt; Paige Hertweck; Amanda Onwuka; Amin Afrazi; Christina Bence; Robert C Burns; Kristine S Corkum; Patrick A Dillon; Peter F Ehrlich; Jason D Fraser; Dani O Gonzalez; Julia E Grabowski; Rashmi Kabre; Dave R Lal; Matthew P Landman; Charles M Leys; Grace Z Mak; R Elliott Overman; Brooks L Rademacher; Manish T Raiji; Thomas T Sato; Madeline Scannell; Joseph A Sujka; Tiffany Wright; Peter C Minneci; Katherine J Deans; Jennifer H Aldrink Journal: J Pediatr Surg Date: 2019-10-25 Impact factor: 2.545
Authors: B J Dicken; D F Billmire; B Rich; F K Hazard; M Nuño; M Krailo; N Fallahazad; F Pashankar; F Shaikh; A L Frazier Journal: Gynecol Oncol Date: 2022-06-22 Impact factor: 5.304