Review of Ovarian Tumors in Children and Adolescents: Radiologic-Pathologic Correlation
Review of Ovarian Tumors in Children and Adolescents: Radiologic-Pathologic Correlation
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DOI：
10.1148/rg.347130144
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发表时间：
2014-11-01
期刊：
影响因子：
5.5
通讯作者：
Kang, Heoung Keun
中科院分区：
文献类型：
--
作者：
Heo, Suk Hee;Kim, Jin Woong;Kang, Heoung Keun
儿科人群卵巢肿瘤的发病率、组织学分布和临床表现与成人不同。尽管儿童和青少年时期的卵巢肿瘤很少见，但对于出现腹痛和可触及肿块的年轻女孩，应考虑诊断。儿童和青少年卵巢肿瘤的鉴别诊断应根据独特的临床表现、血清肿瘤标志物水平升高和独特的影像学表现进行。尽管临床表现不具有特异性并且可能重叠，但它们可能有助于诊断某些类型的卵巢肿瘤。出现明显肿块或性早熟症状的儿童患恶性肿瘤的可能性很高。许多卵巢肿瘤与异常的激素活性和/或异常的性发育有关。血清肿瘤标志物水平升高，包括甲胎蛋白、人绒毛膜促性腺激素的β亚基和CA-125，引起人们对卵巢恶性肿瘤的担忧。然而，肿瘤标志物阴性并不能排除恶性肿瘤的可能性。超声检查、计算机断层扫描和磁共振成像的成像特征识别可以帮助区分良性和恶性卵巢肿瘤，进而在确定治疗方案中发挥至关重要的作用。在成像时，恶性卵巢肿瘤通常主要表现为实性或异质性，并且比良性肿瘤更大。由于手术是卵巢肿瘤的主要治疗方法，因此保留生育能力的卵巢挽救和微创手术技术的使用对于儿童和青少年来说非常重要。 (C) RSNA，2014 年中心点 radiographics.rsna.org
The incidence, histologic distribution, and clinical manifestations of ovarian tumors in the pediatric population are distinct from those in adults. Although ovarian neoplasms in childhood and adolescence are rare, the diagnosis should be considered in young girls with abdominal pain and a palpable mass. Differential diagnosis in children and adolescents with ovarian tumors should be conducted on the basis of unique clinical manifestations, elevated serum tumor marker levels, and distinctive imaging findings. Although the clinical manifestations are nonspecific and may overlap, they may assist in diagnosis of some types of ovarian tumors. Children who present with a palpable mass or symptoms of precocious puberty have a high likelihood of malignancy. Many ovarian tumors are associated with abnormal hormonal activity and/or abnormal sexual development. Elevated levels of serum tumor markers, including a-fetoprotein, the beta subunit of human chorionic gonadotropin, and CA-125, raise concern for ovarian malignancies. However, negative tumor markers do not exclude the possibility of malignancy. Identification of imaging features at ultrasonography, computed tomography, and magnetic resonance imaging can help differentiate benign from malignant ovarian tumors and, in turn, plays a crucial role in determining treatment options. At imaging, malignant ovarian tumors usually appear predominantly solid or heterogeneous and are larger than benign tumors. Because surgery is the primary treatment for ovarian tumors, ovarian salvage with fertility preservation and use of a minimally invasive surgical technique are important in children and adolescents. (C) RSNA, 2014 center dot radiographics.rsna.org