Heartbroken! A teenage girl has a tumor. Parents should pay attention to these three situations...

Three young girls, aged 14, 17 and 18, accidentally found their abdomens growing bigger or had abdominal pain after physical education class, and went to the local hospital for ultrasound examination to find pelvic masses. One of the girls had acute abdominal pain at night and underwent emergency surgery at the local hospital. The pathological diagnosis was a very rare type of ovarian malignant tumor and she was referred here.

Image source: Pixabay

Why do teenage girls also develop tumors, even malignant tumors?

Is it due to congenital genetic inheritance or the influence of acquired life factors?

Can it be cured? Will it affect my future life?

The girls and their parents had question after question on their anxious faces.

Ovarian tumors are uncommon in adolescents and are often benign

The ovaries are an important part of the female reproductive organs and play a special role in reproduction and maintaining female sexual characteristics. The development of the ovaries has its own special characteristics since the embryonic period. During puberty, the ovaries begin to develop and secrete sex hormones to promote the development and maturation of sexual organs. At the same time, due to the complex tissue structure and endocrine function of the ovaries, the pathological types of primary tumors are very wide.

Ovarian tumors are not common in adolescents. According to relevant clinical data, among women under the age of 18, only 2.6 out of 100,000 suffer from ovarian tumors, most of which are germ cell tumors or sex cord-stroma tumors derived from ovarian germ cells, with a malignant transformation rate of 3.7%-23.5%. Ovarian malignant tumors derived from epithelial cells (surface) are even rarer in adolescents. Most adolescent ovarian tumors are benign, and most have a good prognosis.

Image source: Pixabay

These four factors lead to

01The causes of ovarian tumors in adolescents have not yet been fully clarified. According to epidemiological and etiological surveys, ovarian tumors may be related to high cholesterol in the diet.

02 Ionizing radiation, asbestos and talcum powder can affect oocytes and increase the chance of inducing ovarian tumors. Smoking and deficiency of vitamins A, C and E may also be related to the occurrence of ovarian tumors.

03 In addition, the ovarian function that has not yet fully stabilized during adolescence and the repeated damage to the ovarian surface epithelial cells caused by irregular ovulation may also induce tumor growth.

04If a direct female relative in the family has ovarian cancer, endometrial cancer, or breast cancer, genetic gene mutations may also be involved in the formation of ovarian tumors.

Parents should pay attention to these three situations

Ovarian tumors are easier to detect in adolescent women because they are generally slender, with flat abdomens, narrow waists, and small pelvic and abdominal spaces. Ovarian tumors are very obvious when they grow to a certain size. Or they may compress pelvic and abdominal organs, such as bladder compression causing frequent urination and stomach compression causing fullness and other clinical symptoms.

Some ovarian tumors have the function of secreting hormones, which can promote the sexual development and early sexual maturity of young girls, or cause menstrual cycle disorders, irregular vaginal bleeding, etc. These tumors that can secrete hormones mainly include ovarian granulosa cell tumor, ovarian non-gestational choriocarcinoma, ovarian embryonal carcinoma, etc.

The third common clinical condition of ovarian tumors is frequent acute abdominal pain. Emergency surgery reveals that most cases are caused by ovarian tumor pedicle torsion, and occasionally tumor rupture, bleeding or infection. Therefore, young girls need to be educated not to be shy about informing their parents or elders when their abdomen grows, they feel a mass in their abdomen, or encounter the above conditions, which delays the best time for treatment. Ovarian tumors are not difficult to diagnose through appropriate medical history inquiries, detailed physical examinations, abdominal ultrasound, hormone testing, and other means.

Cure while preserving fertility

Although malignant ovarian tumors are rare, since women at this stage all want to have children, while thoroughly treating the disease, it is also necessary to fully consider the patient's future reproductive and endocrine function needs.

Most ovarian tumors in adolescents are benign, so the affected ovarian tumor is often removed. The surgical approach can be minimally invasive laparoscopy or transabdominal surgery, and there is no effect on normal female reproductive function after the operation.

The focus should be on the treatment of adolescent malignant ovarian tumors. The histological type of malignant ovarian tumors in adolescent women is mainly germ cell tumors, which often occur in one ovary and are highly sensitive to chemotherapy. Recurrence in the uterus and contralateral adnexa is also relatively rare. Therefore, regardless of the stage and histological type of germ cell tumors, conservative surgery that preserves fertility can be selected, that is, only the affected adnexa are removed, and the pelvic and abdominal cavities are carefully explored, and biopsies are taken from areas with suspicious lesions to avoid incomplete tumor removal.

Except for FIGO stage I dysgerminoma and stage I, well-differentiated immature teratoma, or patients with high risk of recurrence, sensitive chemotherapy regimens can be selected for adjuvant treatment, followed by follow-up with more sensitive tumor markers. With the continuous development and updating of chemotherapy drugs, the cure rate and long-term survival rate of malignant ovarian germ cell tumors have been greatly improved.

Malignant epithelial ovarian tumors are rare in peripubertal women, but their treatment is more difficult than germ cell tumors because epithelial tumors are more malignant and often have occult implanted metastatic lesions in the contralateral ovary, uterus, pelvic and abdominal cavities. Whether surgery to preserve fertility is feasible remains controversial, and oncologists are required to develop individualized surgical plans based on the specific circumstances of different patients.

Chemotherapy for adolescent malignant ovarian tumors is an important postoperative adjuvant therapy that can effectively reduce recurrence and metastasis, and lay the foundation for the patient's long-term disease-free survival. At present, there are other methods to preserve reproductive capacity for adolescent patients with ovarian malignancies with some special conditions, such as cryopreservation of oocytes, ovarian tissue or the entire ovary before or during surgery, and ovarian transplantation or embryonic stem cell transplantation in the future. However, the related technologies involved are complex and the economic price is relatively expensive.

Source: Chongqing University Cancer Hospital

Reviewer: Gynecological Oncology Center, member of China Medical We-Media Alliance

Statement: Except for original content and special notes, some pictures are from the Internet. They are not for commercial purposes and are only used as popular science materials. The copyright belongs to the original authors. If there is any infringement, please contact us to delete them.