Ovarian Sarcoma in Children.

In a communication shortly to be published* we are recording a case of bilateral ovarian neoplasms in an infant with generalized reticuloendotheliosis and monocytic leuka!mia. The histology of the ovaries showed the tumours to be endotheliomata. The following were the chief features of this case. M. D., aged 1 year, was admitted for wasting, under Dr. Smellie, to the Birmingham Children's Hospital. Bilateral, smooth, freely movable tumours, the size of cocoanuts, were discovered occupying the iliac fossac, and regarded as ovarian sarcomata. There were no general signs of ovarian dysfunction. The tumours were removed by Mr. Scott Mason. After initial improvement the child's condition began to deteriorate, and metastases were suspected. A blood count just before death revealed leukiemia of histiocytic type. No metastases were found at autopsy, but widespread reticulo-endotheliosis was found. Re-examinaation of the ovarian tumours revealed a reticulo-endotheliomatous structure. The case was therefore one of bilateral ovarian endothelioma with generalized reticulo-endotheliomatosis and monocytic (histiocytic) leukaemia. We have been unable to find any other precisely similar case in the literature. We have, therefore, taken the opportunity of reviewing the literature of ovarian sarcoma in infancy, excluding our own case in the category of this disease in enumerating the cases up to date. So closely do such rare tumours as endotheliomata mimic sarcomata that clinical differentiation appears to be impossible, while, though histological differences are present, these are so relatively slight that such processes have been termed reticulum sarcomata by some observers. Owing to these closely similar clinical and pathological features, it appears advisable at present to consider them within the classification of ovarian sarcomata for clinical purposes.