Symbolic illustration of hope and discovery in pediatric oncology

Decoding Ovarian Tumors in Young Girls: A 25-Year Study

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Kai Mendoza in Health & Wellness November 2026 • 5 min read.

"Understanding the prevalence, types, and treatment approaches for ovarian tumors in children and adolescents in India."


Ovarian tumors in children and adolescent girls are rare, yet significant, gynecological malignancies. They account for a small percentage of childhood malignancies, making them an area of concern for both patients and healthcare providers. Understanding the characteristics of these tumors is crucial for early diagnosis and effective treatment.

Historically, ovarian cysts were considered infrequent in young girls due to their origin from mature follicles. However, this perception has evolved, necessitating a deeper understanding of the different types of ovarian tumors and their occurrence in the pediatric population. This article explores a retrospective study conducted over 25 years in a tertiary care hospital in India, aiming to shed light on the incidence and clinicopathological features of ovarian tumors in girls up to 20 years of age.

This research aims to provide clarity on the types of ovarian tumors affecting young girls, their clinical presentation, and effective management strategies. By understanding the specific characteristics of these tumors, healthcare professionals can improve diagnostic accuracy and treatment outcomes.

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Current Burden and Pediatric Context

The CDC provides the latest federal data on ovarian cancer cases and deaths in the U.S. through its ovarian cancer statistics resources. Pediatric ovarian neoplasms account for about 1% of neoplasms in females younger than 17, according to a 2024 review. These tumors are usually benign, although malignant tumors can occur in the pediatric age group. U.S. cancer data can also be explored through CDC Data Visualizations and the National Cancer Institute's SEER statistics resources.

Diagnosis, Surgery, and Their Limits

Evaluation of pediatric and young adult ovarian masses considers clinical, pathological, and surgical characteristics, including malignancy risk, recurrence, and fertility outcomes. Cross-sectional imaging is considered reliable, but it is not always performed. The available review notes that laparoscopic tumourectomy is popular but is not recommended by the International Paediatric Surgical Oncology Society because tumor spillage remains a central concern. Transabdominal imaging is generally not considered compromised in children because of their smaller size, relatively lower abdominal fat, and the often larger size of ovarian tumors.

A Distinct Pediatric Tumor Spectrum

Foundational descriptions of childhood and adolescent ovarian tumors recognize a broad range of entities derived from germinative, stromal, and epithelial components. In children and adolescents, malignant tumors are predominantly of germinal origin, comprising 70% of cases in the cited Springer source. Epithelial tumors, which are most common in adults, account for approximately 15% of pediatric and adolescent cases and become more frequent in adolescents and young adults. More recent clinical reviews emphasize imaging, tumor markers, and fertility-sparing surgery when possible.

Key Findings: Types, Prevalence, and Malignancy

Symbolic illustration of hope and discovery in pediatric oncology

The study analyzed 112 cases of ovarian tumors in girls up to 20 years of age, revealing a mean age of 15.3 years at diagnosis. The most common presenting complaint was abdominal pain, highlighting the importance of considering ovarian masses in young girls presenting with this symptom. The study found a statistically significant correlation between the size of the tumor and its malignancy status, emphasizing the need for careful evaluation of larger masses.

The research categorized the ovarian tumors into benign and malignant types, revealing the prevalence of each. Mature cystic teratomas were the most common benign tumors, while immature teratomas were the most common malignant neoplasms. The study also noted the incidence of other tumor types, such as serous cystadenomas and mucinous cystadenomas, providing a comprehensive overview of the spectrum of ovarian tumors in this age group.

  • Mature Cystic Teratomas: Most common benign tumor (27.6%)
  • Immature Teratomas: Most common malignant tumor (8%)
  • Abdominal Pain: Most frequent presenting complaint (46.4%)
  • Malignancy Rate: 34.8% of the studied cases were malignant.
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Evidence-Based Pediatric Care

The National Cancer Institute's Childhood Ovarian Cancer Treatment PDQ is an evidence-based, expert-reviewed summary of pediatric ovarian cancer. It covers clinical presentation, risk factors, histology, molecular features, prognosis, and treatment. This scope reflects the need to integrate pathological and molecular information with clinical management when studying ovarian cancer in children.

Outcomes in Tertiary Care

A 2025 study examined pediatric patients with ovarian cancer and borderline masses presenting to a large tertiary pediatric hospital. Its focus was the patients' clinical characteristics, interventions, and outcomes. Because the study addresses a specific urban tertiary-hospital population, its findings describe that care setting rather than necessarily representing every child with an ovarian malignancy.

Pediatric Versus Adult Priorities

Ovarian cancer in children and adolescents is rare and presents diagnostic and management challenges distinct from adult disease. A recent overview emphasizes multidisciplinary care for this population. Pediatric treatment must balance appropriate surgical management with preservation of future reproductive capability. Preoperative estimation of malignant potential is therefore important when selecting an optimal surgical strategy.

The study also explored the laterality, size and treatment approaches for ovarian tumors. The majority of cases were unilateral, and the size of the tumor was significantly correlated with its malignancy status. Treatment options included cystectomy and unilateral salpingo-oophorectomy, with the choice depending on the tumor type and extent of the disease. In a few cases, total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed for advanced-stage malignant tumors.

Translating Findings into Improved Care

This research underscores the importance of maintaining a high index of suspicion for ovarian masses in young girls presenting with abdominal pain. Prompt investigations, such as ultrasound, are crucial for early detection and accurate diagnosis. By recognizing the varied presentations of ovarian tumors and understanding their prevalence, healthcare professionals can expedite the diagnostic process and initiate timely treatment.

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Frozen Section and Surgical Decisions

Frozen section is used as an intraoperative aid when clinicians must determine the extent of surgical staging. A review specifically assessed concordance between intraoperative frozen-section results and final diagnoses in pediatric and adolescent patients with malignant ovarian germ cell tumors. The purpose is to guide surgical decisions while awaiting definitive pathology. Its usefulness therefore depends on how closely the intraoperative assessment matches the final diagnosis.

Fertility and Quality of Life

Future care for ovarian cancer in children and adolescents is framed around achieving oncological control while preserving future fertility and quality of life. A 2024 review aims to guide clinicians toward optimal care for this distinct patient population. This outlook places reproductive and long-term quality-of-life outcomes alongside cancer treatment when evaluating progress.

A Biology Different from Adult Disease

Pediatric ovarian cancers create challenges that differ substantially from those encountered in adults. Research on microRNAs and pediatric ovarian cancers reviews the spectrum of cancers found in girls and young women while focusing on the biology of these diseases. The distinct biology adds complexity to diagnosis and treatment and supports studying pediatric tumors as their own clinical group rather than simply applying adult assumptions.

Living Through Uncertainty

For a girl and her family, an ovarian mass can bring uncertainty about diagnosis, treatment, and long-term reproductive health. The available material supports viewing care as a balance between controlling disease and protecting future fertility and quality of life. Because no subsection-specific source was provided for this human-impact discussion, these points are presented broadly rather than as quantified outcomes.

The study highlights the effectiveness of surgical interventions, such as cystectomy and salpingo-oophorectomy, in managing ovarian tumors in young girls. The choice of treatment should be tailored to the individual patient, considering the tumor type, stage, and extent of the disease. A multidisciplinary approach, involving surgeons, oncologists, and pathologists, is essential for optimizing treatment outcomes and preserving fertility whenever possible.

While this study provides valuable insights into the spectrum of ovarian tumors in young girls in India, further research is needed to explore the long-term outcomes and quality of life of these patients. Additionally, studies are needed to identify potential risk factors and develop preventive strategies to reduce the incidence of ovarian tumors in this vulnerable population. By continuing to invest in research and innovation, we can improve the lives of young girls affected by ovarian tumors and ensure they receive the best possible care.

What a 25-year pathology review can establish

Observational study (level 4 of 8)

The review included girls up to age 20 and examined incidence and clinicopathological features. Its case series supports descriptions of those patients, not conclusions about causes or outcomes beyond the cases studied.[1]

A varied pattern within the hospital's cases

The age pattern was not uniform: the study describes similar numbers of benign and malignant tumors through age 14, with both more frequent among girls older than 15. This describes the distribution in the reviewed cases, rather than an age-based risk estimate for girls generally.[2]

The tumor types also varied by age: dysgerminomas were reported among girls older than 9, while immature teratomas appeared across age groups. The findings show why a single tumor pattern does not describe every age in this case series.[2]

Limits visible in the study record

  • The authors noted that close follow-up was not considered necessary for benign tumors when involvement was unilateral, limiting follow-up information for that group.[2]
  • Some ovarian masses were found during surgery after clinicians had suspected appendicitis; two of those cases involved cyst torsion, illustrating diagnostic uncertainty in individual cases.[2]

A retrospective review of ovarian tumors in girls at a Delhi tertiary hospital

Study designObservational study[1]
PopulationGirls up to 20 years of age with ovarian tumours[1]
Sample size112 cases[1]
SettingDepartment of Pathology at a tertiary hospital, Delhi[1]
Duration25 years (1990-2014)[1]
Main outcomeIncidence and clinicopathological features of ovarian tumours[1]
Effect size39/112 (34.8%) were malignant and 73/112 (65.2%) were benign[1]
p-valuep = 0.00[1]
Times cited24[1]

Questions this review leaves unresolved

  • Would the age and tumor-type patterns look similar in hospitals beyond this tertiary pathology department?[1] [2]
  • How did the patients fare over time, particularly those with malignant tumors or those whose benign tumors were not closely followed?[1] [2]

Sources

  1. Spectrum of Childhood and Adolescent Ovarian Tumors in India: 25 Years Experience at a Single Institution (Scientific Foundation Spiroski (publications), 2016)
  2. Spectrum of Childhood and Adolescent Ovarian Tumors in India: 25 Years Experience at a Single Institution (Europe PMC, 2016)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3889/oamjms.2016.090, Alternate LINK

Title: Spectrum Of Childhood And Adolescent Ovarian Tumors In India: 25 Years Experience At A Single Institution

Subject: General Medicine

Journal: Open Access Macedonian Journal of Medical Sciences

Publisher: Scientific Foundation SPIROSKI

Authors: Ruchi Rathore, Sonal Sharma, Deepshikha Arora

Published: 2016-09-30

Everything You Need To Know

1

What is the most common symptom that young girls experience when they have an ovarian tumor, and why is it important?

Abdominal pain is the most frequent presenting complaint, occurring in 46.4% of cases studied. When young girls present with abdominal pain, it is crucial to consider ovarian masses in the differential diagnosis. This symptom should prompt further investigation, such as ultrasound, to rule out or confirm the presence of an ovarian tumor and determine the appropriate course of action.

2

What are the most common types of benign and malignant ovarian tumors found in young girls, according to the 25-year study?

The study found that mature cystic teratomas were the most common benign ovarian tumors, accounting for 27.6% of cases. These tumors are typically slow-growing and non-cancerous. On the other hand, immature teratomas were the most common malignant ovarian neoplasms, representing 8% of the studied cases. These tumors are cancerous and require more aggressive treatment approaches. Other types of ovarian tumors, such as serous cystadenomas and mucinous cystadenomas, were also noted in the study.

3

How does the size of an ovarian tumor relate to its likelihood of being cancerous in young girls?

The study indicates a significant correlation between tumor size and malignancy status, emphasizing the need for careful evaluation of larger masses. Larger ovarian tumors are more likely to be malignant, requiring more aggressive treatment approaches. Therefore, healthcare professionals should pay close attention to the size of the tumor when assessing the risk of malignancy and determining the appropriate treatment strategy.

4

What are the different treatment options available for ovarian tumors in young girls, and how is the choice of treatment determined?

Treatment options for ovarian tumors in young girls include cystectomy and unilateral salpingo-oophorectomy. Cystectomy involves the surgical removal of the cyst or tumor while preserving the ovary. Unilateral salpingo-oophorectomy involves the removal of one ovary and fallopian tube. The choice of treatment depends on the tumor type, size, and extent of the disease. In advanced-stage malignant tumors, total abdominal hysterectomy with bilateral salpingo-oophorectomy may be performed, involving the removal of the uterus, both ovaries, and fallopian tubes.

5

What are the long-term effects on fertility for young girls who undergo treatment for ovarian tumors, and are there any strategies to preserve fertility?

The study did not delve into the long-term effects on fertility for young girls who undergo treatment for ovarian tumors. Depending on the treatment approach, such as unilateral salpingo-oophorectomy or more extensive procedures like total abdominal hysterectomy with bilateral salpingo-oophorectomy, there could be implications for future fertility. Fertility preservation strategies and counseling should be considered for young girls diagnosed with ovarian tumors to address potential concerns and provide support for their reproductive health.

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