Fertility sparing surgery for ovarian tumors in children and young adults.

Objectives: To study the outcome of fertility conserving surgery for ovarian tumors in children and young adults (≤ 20 years) over 6 years (2003-2009).

Methods: This prospective study included 183 patients diagnosed with ovarian cysts or tumors requiring surgical excision. Ovarian cystectomy/ovariectomy was carried out followed by frozen section histopathology. Malignant cases were subjected to staging laparotomy and fertility sparing surgery.

Results: The median age at diagnosis was 17 years (range 7-20 years). 160/183 (87.4%) were non-neoplastic ovarian cysts or benign tumors. In 131/160 (81.8%) of non-neoplastic and benign tumors, it was possible to preserve the affected ovary. Twenty cases (11%) were diagnosed as primary malignant ovarian tumors, 2/183 (1.1%) were borderline tumors and 1 case (0.55%) was metastatic colonic carcinoma. The median follow up of cases with primary malignant ovarian tumors was 36 months. During this period, two recurrences (9.1%) were detected, both of the germ cell type (immature teratoma and yolk sac tumor). Recurrent cases were managed by local excision and lymph node sampling followed by chemotherapy.

Conclusion: Fertility sparing surgery for malignant ovarian tumors in children and young adults has excellent prognosis and should be attempted whenever possible.