Nelson's Club Repro Lecture

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Gynecologic Problems of ChildhoodNelsons Club April 2011

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Neoplasms Most common gynecologic neoplasm found in children of ovarian origin usually presents as an abdominal mass Ovarian neoplasms constitute 1% of all childhood malignancies 8% of all malignant and abdominal tumors in childrenFree Powerpoint Templates Page 2

Neoplasms Ovarian neoplasms 10-30% of the ovarian neoplasms operated on during childhood or adolescence are malignant Other common neoplasms: Paraovarian tumors Uterine neoplasms

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Neoplasms Vagina or vulva may also be the site of a benign or malignant lesion in children Cervical dysplasia may occur in adolescents Chemotherapy, especially with alkylating agents is associated with germ cell damage in the postpubertal ovary

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Neoplasms Prepubertal ovary, on the other hand, is markedly resistant to chemotherapeutic damage of germ cells Survivors of childhood cancer who previously underwent abdominal or gonadal irradiation have an increased rate of spontaneous abortions

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Ovaries Neonatal and Pediatric Ovarian cysts o most often clinical manifestations of ovarian tumors are abdominal pain, mass, or both Teratoma the most common neoplasm in adolescents; are usually benign -Calcification on abdominal roentgenogram is often a hallmark of a benign teratomaFree Powerpoint Templates Page 6

Ovaries Ovarian adenomas are the second most common benign tumor Ovarian cancers are extremely uncommon in children, but are responsible for 1:500 ovarian malignancies; affect only 4% of women

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OvariesDysgerminoma - The most common germ cell tumor - Other germ cell tumors are malignant teratomas, endodermal sinus tumors, embryonal carcinomas, mixed cell neoplasms, and gonadoblastomas

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OvariesImmature teratomas and endodermal sinus tumors - more aggressive malignancies than dysgerminomas - occur in a significantly higher proportion of younger girls (