Understanding And Treating Gynaecological Tumours In Children, Adolescents

KUALA LUMPUR, Sept 25 (Bernama) -- Gynaecological tumours in children and adolescents are rare but present complex conditions that require better understanding and timely treatment, especially in a healthcare landscape where such cases are often overlooked or misdiagnosed.

Even the Malaysian Society of Paediatric Haematology and Oncology estimates an incidence of about 77.4 per million children under 15, with childhood cancers differing significantly from adult cancers in how they present and respond to treatment.

According to Dr Shona Alison Edmonds, Consultant Paediatric Surgeon at Sunway Medical Centre, Sunway City (SMC), early awareness and a multidisciplinary approach are key to improving outcomes and preserving the future quality of life for affected children.

Dr Shona and her team estimate they see about five paediatric gynaecological tumour cases annually, with most patients ranging from infancy to teenage years and ovarian tumours being the most common. 

Some present with acute pain needing emergency care, but many show subtle signs that can go unnoticed for weeks or months, especially in girls without prior gynaecological issues.

“Chronic constipation in a previously regular child should raise concern, especially if unresponsive to laxatives or diet,” she said.

Dr Shona said frequent urination without a UTI is another warning sign, possibly indicating pelvic mass pressure, while abdominal bloating is another key but often overlooked symptom

“Parents or the child might notice vague fullness, hardness, or swelling. Sometimes, the child feels a lump or discomfort that’s hard to explain. These subtle signs warrant further investigation, usually starting with a simple ultrasound,” she said.

However, she noted that a major barrier to timely diagnosis is a lack of awareness among the public and medical practitioners.

“There’s a misconception that children don’t get gynaecological tumours, especially prepubertal girls. When teenagers show symptoms, it’s often misattributed to infections or sexual activity, delaying proper intervention,” the doctor explained.

Dr Shona also highlighted systemic delays: patient-related, like fear of negative news or seeking alternative treatments, and physician-related, where GPs and some paediatricians may not know the correct referral pathway.

A child with a suspected tumour should be seen and managed primarily by a paediatric oncologist, she said.

On fertility preservation, Dr Shona said that while it is important, it must never come at the expense of a child’s survival.

“Older girls may delay treatment by two weeks to preserve eggs; in younger girls, ovarian tissue cryopreservation offers hope,” she said.

Dr Shona said when a child presents with a gynaecological tumour, coordinated care becomes crucial, hence the need for a multidisciplinary team approach to address all aspects of the child’s well-being.

“The paediatric oncologist usually serves as the gatekeeper. From there, the team is then coordinated to involve paediatric surgeons, radiologists, pathologists, psychologists or psychiatrists, social workers, play therapists and increasingly, adolescent and fertility gynaecologists,” she said.

Her advice to families is simple but powerful: “Don’t delay treatment. If you need a second opinion, seek it from a qualified medical practitioner. Most importantly, choose a centre that sees your child as more than a tumour.”

Dr Shona also shared these insights in her presentation titled ‘Gynae Tumours in Children and Teens - Bridging the Gap’ at SMC’s 2nd International Paediatric Symposium under the theme “Paediatrics Without Borders: Bridging Subspecialties, Saving Lives” which brought together leading experts from across the globe to tackle urgent child health challenges.

SMC has been ranked the top hospital for paediatrics in Malaysia for three consecutive years by Newsweek in its Best Specialised Hospitals Asia Pacific rankings since 2023.

Home to dedicated Children and Women’s Centres of Excellence, SMC is also the first private hospital in Malaysia to offer a 24-hour Children’s Emergency Department, supported by 26 paediatric subspecialties and 50 consultants and accredited by the Australian Council on Healthcare Standards (ACHS) International, Malaysian Society for Quality in Health (MSQH) and the Joint Commission International (JCI) from the United States. 

-- BERNAMA