The aim of this study is to examine the importance of tumor markers in the diagnosis of adnexal masses in pediatric and adolescent gynecology.

Relevant studies published over the last 20 years were identified by a PubMed/Medline search using different combinations of the following search terms: “tumor markers”, “adnexal masses” and “pedaitric and adolescent gynecology”. Additional papers were identified by reviewing reference lists of relevant publications. Particular emphasis was placed on original studies. Non-English publications were excluded. A systematic approach to study selection was not implemented. Instead, data were extracted based on their relevance to the topic.

By searching the literature, we found out 5 studies that met our criteria¹־⁵. Fifteen studies that were not original studies and represented a review of the literature and previously published studies were excluded.

Literature review consisted of 5 remarkable articles in the period from 1996–2016 and included 796 pediatric and adolescent patients with neoplastic ovarian masses and increase of tumor markers¹־⁵. Out of the total number of patients 127 (15.9%) were malignant ovarian tumors ¹־⁵. Lawrence et al in their study they found sensitivity and specifity for CA 125 59% and 81%, for CA 19-9 25% and 73%, for CEA 5% and 100%, for AFP 42% and 98%, for LDH 95% and 13%, for beta HCG 44% and 76%, for Inhibin A 32% and 97%, for Inhibin B 37% and 92%.² Lawrence et al reported proportion of cohort that received tumor marker testing for AFP 94%, beta HCG 78%, CA 125 54%, LDH 39%, CEA 26%, Inhibin A 25%, Inhibin B 23%, CA 19-9 13%.² Spinelli et al reported proportion of tumor marker testing in 88.3%.² Elevated values of tumor markers in malignant adnexal masses ranged from 54% to 100%.²ʼ³ʼ⁴

Tumor markers are important in the preoperative evaluation and differential diagnosis of adnexal masses in pediatric and adolescent gynecology, but also in making a decision about the radicality or fertility-sparing surgical procedure. When malignancy is suspected, a panel of tumor markers is necessary, because there is no single tumor marker that is sufficiently reliable. International collaborations and prospective studies are necessary to determine the reliable predictive value of tumor markers in the preoperative evaluation of adnexal masses.