Abstract:
Background: The main pediatric (0–18 years) gynecologic cancers include stromal carcinomas (juvenile granulosa
cell tumors and Sertoli-Leydig cell tumors), genital rhabdomyosarcomas and ovarian germ cell. Outcomes
depend on time of diagnosis, stage, tumor type and treatment which can have long-term effects on the reproductive career of these patients. This study seeks to analyze the trends in clinical-pathologic presentation,
treatment and outcomes in the cases seen at our facility. This is the frst paper identifying these cancers published
from sub-Saharan Africa.
Method: Retrospective review of clinico-pathologic profles and treatment outcomes of pediatric gynecologic
oncology patients managed at MTRH between 2010 and 2020. Data was abstracted from gynecologic oncology
database and medical charts.
Results: Records of 40 patients were analyzed. Most, (92.5%, 37/40) of the patients were between 10 and 18
years. Ovarian germ cell tumors were the leading histological diagnosis in 72.5% (29/40) of the patients; with
dysgerminomas being the commonest subtype seen in 12 of the 37 patients (32.4%). The patients received
platinum-based chemotherapy in 70% of cases (28/40). There were 14 deaths among the 40 patients (35%)
Conclusion: Surgery remains the main stay of treatment and fertility-sparing surgery with or without adjuvant
platinum-based chemotherapy are the standard of care with excellent prognosis following early detection and
treatment initiation. LMICs face several challenges in access to quality care and that affects survival of these
patients. Due to its commonality, ovarian germ cell cancers warrant a high index of suspicion amongst primary
care providers attending to adnexal masses in this age group.
