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Ovarian small cell carcinoma of the hypercalcemic type in children and adolescents
Author(s) -
Distelmaier Felix,
Calaminus Gabriele,
Harms Dieter,
Sträter Ronald,
Kordes Uwe,
Fleischhack Gudrun,
Göbel Ulrich,
Schneider Dominik T.
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22213
Subject(s) - medicine , chemotherapy , disease , stage (stratigraphy) , ovarian carcinoma , carcinoma , carboplatin , germ cell tumors , oncology , surgery , ovarian cancer , cancer , cisplatin , paleontology , biology
BACKGROUND. Ovarian small cell carcinoma of the hypercalcemic type is a rare neoplasm that is associated with a poor prognosis. The objective of the current study was to investigate the clinicopathologic features of this tumor and to develop preliminary diagnostic and therapeutic guidelines. METHODS. Between 1994 and 2005, 11 girls (ages 9–22 years) who were registered on the German Maligne Keimzelltumoren studies and the Kiel Pediatric Tumor Registry were analyzed. Prior to histopathologic review, 8 patients had been misdiagnosed with either germ cell tumor or juvenile granulosa cell tumor. RESULTS. According to the International Federation of Gynecologic Oncology, 4 patients had Stage IA disease, 3 patients had Stage IC disease, and 4 patients had Stage III disease. After resection, 4 patients were followed without additional therapy, and all 4 patients developed recurrent disease after 3 to 11 months. Seven patients received adjuvant chemotherapy during first‐line treatment. One patient with Stage III disease received additional regional deep hyperthermia. During first‐line treatment, high‐dose chemotherapy was received by 4 patients who achieved a complete response (CR) after conventional chemotherapy. All 4 of those patients remained in CR for 7 to 73 months, whereas the other 3 patients developed recurrent disease. Salvage treatment after recurrence or tumor progression consisted of surgery and chemotherapy. One patient received high‐dose chemotherapy in 2nd CR and remained in 2nd CR. In total, 5 patients remained alive with no evidence of disease. CONCLUSIONS. Patients with ovarian small cell carcinoma of the hypercalcemic type require multiagent chemotherapy during first‐line treatment. High‐dose chemotherapy may be used to consolidate the therapeutic success. Cancer 2006. © 2006 American Cancer Society.