Premenarchal gynecologic malignant tumors: a review of 55 cases.

Objective To evaluate the clinical characteristics,treatment and prognosis of premenarchal gynecologic malignant tumors.Methods Patients admitted between November 1985 and July 2008 with premenarchal gynecologic malignant tumors were retrospectively analyzed.Results There were 55 cases of premenarchal gynecologic malignant tumors,which was 0.9% of the total gynecologic malignant tumors at the corresponding period.Age range was 10 months to 14 years old there were 7 cases(12.7%) at the age of less than 5 years old,24 cases(43.6%) at the age from 5 to 10 years old and 24 cases(43.6%) at the age more than 10 years old,respectively.There were ovarian(47),vaginal(6),vulvar tumors(1),and pelvic embryonal rhabdomyosarcoma(1).In the ovarian tumors,there were 10 cases of endodermal sinus tumors,10 cases of immature teratomas,7 cases of mixed germ cell tumor,7 cases of disgerminoma,2 cases of embryonal carcinoma,2 cases of trophoblastoma.The endodermal sinus tumor(3 cases)was the most common type in vaginal tumors.The case of vulvar tumor was Merkel cell carcinoma of clitoris.The 47 cases of ovarian tumors and pelvic embryonal rhabdomyosarcoma all received surgery and 46 cases preserved fertility,46 cases received chemotherapy.Five cases of vaginal tumors with the pathological diagnosis received chemotherapy.The case of vulvar tumor received both surgery and chemotherapy.Survival rate was 78.2% and recurrence rate was 29.1% during the follow-up period(mean 52 months).Conclusion The common premenarchal gynecologic malignant tumors were ovarian and vaginal tumors,gynecologic examinations should not be neglected.Both operation completeness and fertility preservation should be considered.