The treatment outcome of childhood dysgerminoma

Yıl 2021, Cilt: 31 Sayı: 3, 248 - 251, 20.09.2021

Buket Kara Hilal Akbaş İlhan Çiftçi Yavuz Köksal

https://doi.org/10.54005/geneltip.996767

Öz

Objective: To review retrospectively the demographic and clinical features and treatment approaches of patients with ovarian dysgerminoma.

Material and Methods: The files of pediatric patients diagnosed with ovarian dysgerminom between 2006-2020 at XXXXX University Faculty of Medicine, Department of Pediatric Oncology were reviewed retrospectively.

Results: Ten patients with dysgerminoma were included in the study. The ages of the patients ranged from 8 to 17 years (median, 12.5 years). While the mass was unilateral in nine patients (90%), it was bilateral in one patient (10%). In all patients, complaints of application were abdominal swelling and abdominal pain. Ovarian torsion developed in one patient. Preoperative alpha-feto protein levels were within normal limits in seven patients, while hCG levels were high in all seven patients. The lactate dehydrogenase enzyme level was measured in five patients and was high in all. Five patients underwent primary surgery, and all of these patients were in stage I. Additional treatment was not given. Neoadjuan treatment was applied in three patients due to bilateral disease or common disease. The follow-up time of patients ranged from one year to 13 years (median, 5.5 years). The overall survival rate of the patients was 87.5%.

Conclusion: Disgerminoma should be considered in rapidly developing intraabdominal masses especially in peripubertal girls and treatment planning should be done accordingly.

Anahtar Kelimeler

children, ovary, dysgerminoma

Çocukluk çağı disgerminom tedavi sonuçları

Öz

Amaç: Over disgerminomu tanısı ile izlenen hastala­rın demografik ve klinik özellikleri ile tedavi yaklaşımlarını geriye dönük olarak incelemektir.

Gereç ve Yöntem: XXXXXX Üniversitesi Tıp Fakültesi Çocuk Onkoloji Bilim Dalı’nda, 2006-2020 yılları arasında over disgerminom tanısı alan çocuk hastaların dosyaları geriye dönük olarak incelendi.

Sonuç: On disgerminom tanısı alan hasta çalışmaya dâhil edildi. Hastaların yaşları 8 ile 17 yıl arasında değişmekteydi (ortanca, 12,5 yıl). Dokuz hastada kitle tek taraflı iken (%90), bir hastada iki taraflıydı (%10). Tüm hastalarda, başvuru şikâyetleri karında şişlik ve karın ağrısı idi. Bir hastada over torsiyonu gelişmişti. Yedi hastada ameliyat öncesi alfa föto protein düzeyleri normal sınırlarda iken, hCG düzeyleri yedi hastanın tamamında yüksekti. Laktat dehidrojenaz enzim düzeyi beş hastada bakılmıştı ve hepsinde yüksekti. Beş hasta primer cerrahi uygulandı ve bu hastaların tamamı evre I’di ek tedavi verilmedi. Üç hastada, bilateral hastalık ya da yaygın hastalık nedeniyle neoadjuan tedavi olarak uygulandı. Hastaların izlem süreleri bir yıl ile 13 yıl arasında değişmekteydi (ortanca, 5,5 yıl). Hastaların genel yaşam oranı % 87,5 idi.

Yorum: Özellikle ergenlik çağına yakın kız hastalarda hızlı büyüyen karın içi kitlelerde disgerminom akla gelmeli ve tedavi planlaması buna göre yapılmalıdır.

Anahtar Kelimeler

Çocuk, over, disgerminom

Kaynakça

• Çiftçi İ, Köse D, Köksal Y, Günel E. Çocukluk çağında gonad tümörleri. Genel Tıp Derg 2012; 22: 98-101.
• Akyüz C, Varan A, Büyükpamukçu N, Kutluk T, Büyükpamukçu M. Malignant ovarian tumors in children: 22 years of experience at a single institution. J Pediatr Hematol Oncol 2000; 22: 422-7.
• Wang Q, Yu D, Wang F. Clinical and computed tomography features of female pelvic malignant germ cell tumors in children and adolescents: A series of 30 cases. J Pediatr Adolesc Gynecol 2020; 33: 83-8.
• Smith HO, Berwick M, Verschraegen CF, Wiggins C, Lansing L, Muller CY, et al. Incidence and survival rates for female malignant germ cell tumors. Obstet Gynecol 2006; 107: 1075-85.
• Gershenson DM. Ovarian germ cell tumors: Pathology, epidemiology, clinical manifestations, and diagnosis. https://www.uptodate.com/contents/ovarian-germ-cell-tumors-pathology-epidemiology-clinical-manifestations-and-diagnosis?search=disgerminoma&source=search_result&selectedTitle=1~15&usage_type=default&display_rank=1#H21
• Koksal Y, Caliskan U, Ucar C, Yurtcu M, Artac H, Ilerisoy-Yakut Z, et al. Dysgerminoma in a child with ataxia-telangiectasia. Pediatr Hematol Oncol 2007; 24: 431-6.
• Bernstein L, Smith MA, Liu L, Deapen D, Friedman DL. Germ cell, trophoblastic and other gonadal neoplasms. Ries LAG, Smith MA, Gurney JG, Linet M, Tamra T, Young JL, Bunin GR (eds). Cancer Incidence and Survival among Children and Adolescents: United States SEER Program 1975-1995, National Cancer Institute, SEER Program. NIH Pub. No. 99-4649. Bethesda, MD, 1999.
• Raney RB Jr, Sinclair L, Uri A, Schnaufer L, Cooper A, Littman P. Malignant ovarian tumors in children and adolescents. Cancer 1987; 59: 1214-20.
• Castleberry RP, Cushing B, Perlman E, Hawkins EP. Germ cell tumors. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 3rd ed. Philadelphia: Lippincott-Raven, 1997; 921–45.
• Olson TA. Germ cell tumor. In: Lanzkowsky P, Liptom JM, Fish JD, eds. Lanzkowsky’s Manual of Pediatric Hematology and Oncology. 6th ed. Amsterdam: Elsevier, 2016; 555-68.
• Shaaban AM, Rezvani M, Elsayes KM, Baskin H Jr, Mourad A, Foster BR, et al. Ovarian malignant germ cell tumors: cellular classification and clinical and imaging features. Radiographics 2014; 34: 777-801.
• Lu KH, Gershenson DM. Update on the management of ovarian germ cell tumors. J Reprod Med 2005; 50: 417-25.
• A L Husaini H, Soudy H, El Din Darwish A, Ahmed M, Eltigani A, A L Mubarak M, et al: Pure dysgerminona of the ovary: a single institutional experience of 65 patients. Med Oncol 2012; 29: 2944–8.
• Joki-Erkkilä MM, Karikoski R, Rantala I, Lenko HL, Visakorpi T, Heinonen PK. Gonadoblastoma and dysgerminoma associated with XY gonadal dysgenesis in an adolescent with chronic renal failure: a case of Frasier syndrome. J Pediatr Adolesc Gynecol 2002; 15: 145-9.