What Are Childhood Ovarian Tumors?
Ovarian tumors can form in infants, young girls, and adolescents on one or both ovaries. Ovaries are organs that store and release eggs and produce female hormones.
- Ovarian tumors account for one percent of all malignant tumors found in children between birth and age 17. In girls younger than eight, four out of five ovarian tumors are benign (noncancerous).
- Ovarian tumors are different from ovarian cysts. Tumors are solid masses of tissue, while cysts contain fluid, tissues, or other materials.
- Some ovarian cysts can become malignant (cancerous). Non-functional cysts, which do not go away on their own and are not associated with a woman producing an egg each month, can become malignant.
- In children and adolescents, ovarian tumors have a much higher cure rate than adult forms of ovarian cancer.
Children with benign (noncancerous) ovarian tumors receive care from specialists at Boston Children’s Gynecology Program.
If your child’s ovarian tumor is cancerous, experts from the Dana-Farber/Boston Children's Solid Tumor Center, including pediatric oncologists and gynecologists, will be on your child’s medical team.
Causes and Symptoms of Childhood Ovarian Tumors
Doctors do not completely understand the cause of most ovarian tumors. While ovarian tumors often occur with no known cause, there are some risk factors, including:
- Inherited gene mutations
- Breast cancer gene 1 (BRCA1)
- Breast cancer gene 2 (BRCA2)
- Family history of ovarian cancer
- Previous cancer diagnosis
Ovarian tumors sometimes don't produce symptoms. Their symptoms can also depend on the tumor’s size and location.
Ovarian tumor symptoms may include:
- A feeling of pressure or fullness in the abdomen or pelvis
- A firm, painless swelling in the lower abdomen
- Frequent urination or retention of urine
- Persistent abdominal pain
Among girls younger than 8, an ovarian tumor or cyst may cause secretions of estrogen, producing:
- Breast enlargement
- Pubic hair
- Vaginal discharge or bleeding
- Abnormal menstrual bleeding
How We Diagnose and Classify Childhood Ovarian Tumors
If your doctor suspects an ovarian tumor, they will order several diagnostic tests, ranging from imaging studies to pelvic exams.
We also use these tests to determine the tumor’s size, grade, and stage. We classify ovarian tumors as one of three types:
- Epithelial cell tumors: These are the most common type of ovarian tumor and develop from the ovaries’ surface.
- Germ cell tumors: These tumors develop in the egg-producing cells. Most are benign, but a few are cancerous.
- Stromal tumors: These growths develop in the female hormone-producing cells.
Your child’s treatment team will take the results and decide together on the most effective treatment plan for your child. We share our recommendations with you, discuss the options, and answer all of your questions.
How We Treat Childhood Ovarian Tumors
Our doctors utilize the latest pediatric ovarian tumor treatment approaches. We always personalize your child’s treatment plan to use the treatments that will be most effective for their unique needs.
Your child’s treatment may include:
- Surgery: We treat most ovarian tumors with surgery. Our pediatric gynecologic surgeons remove as much of the tumor as possible while attempting to maintain your child’s reproductive function. If the tumor is cancerous and has spread, we may need to remove the ovaries, uterus, fallopian tube, omentum (fatty tissue covering the intestines), and lymph nodes.
- Chemotherapy: Chemotherapy is a drug that interferes with the cancer cell's ability to grow or reproduce. When we use chemotherapy before surgery, it may help shrink the tumor and make surgery easier. If we recommend it after surgery, it’s to help fight the cancer's recurrence. Different groups of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors. Your child may receive chemotherapy:
- Orally, as a pill to swallow
- Intramuscularly, as an injection into the muscle or fat tissue
- Intravenously (IV) as a direct injection into the bloodstream
- Intrathecally, as a direct injection into the spinal column through a needle
- Radiation therapy: Our doctors use high-energy rays from a specialized machine to damage or destroy cancer cells and shrink tumors.
- Supportive care: Throughout your child's treatment, our doctors use supportive care to prevent and treat infections, minimize side effects of treatment, respond to complications, and keep your child comfortable. These may include medications, dietary recommendations, and integrative therapies such as acupuncture, acupressure, and massage.
After treatment, your child will receive ongoing care from our clinicians and support staff. We will monitor for cancer recurrence, late effects of treatment, and future reproductive issues. Our pediatric cancer survivorship programs also include psychosocial and nutritional support.
We also offer patient and family education, psychosocial assessment, genetic counseling and risk assessment, reproductive and fertility evaluation and counseling, and opportunities to speak with other childhood cancer survivors.