Sonographic detection of uterine and ovarian abnormalities in female survivors of Wilms' tumor treated with radiotherapy

Anna R. Nussbaum Blask, H. Stacy Nicholson, Bruce M. Markle, Kaethe Wechsler-Jentzch, Regina O'Donnell, Julianne Byrne

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Abstract

OBJECTIVE. The purpose of this study was to use sonography to evaluate the size of the ovaries and uterus in survivors of Wilms' tumor who underwent radiotherapy. SUBJECTS AND METHODS. Eighteen survivors of Wilms' tumor had their ovaries and uterus measured on sonography. Their ages at diagnosis and treatment ranged from 14 months to 6 years. Four girls were prepubertal (age, 5-9 years), 11 were postpubertal (age, 11-30 years), and three had primary ovarian failure (age, 15-23 years) at the time of imaging. Findings were compared with those of a control group of 25 prepubertal and 25 postpubertal girls and women. Gonadotropin levels were measured. RESULTS. Three patients who underwent whole abdomen radiotherapy had elevated levels of gonadotropin and primary ovarian failure. Neither ovary was seen in two of the three patients and both ovaries were abnormally small (≤1 cm3) in the third patient. The uterus was abnormally small (length, ≤4 cm) in all three of these patients even though two were being treated with hormone replacement therapy. Ten postpubertal patients who underwent hemiabdomen radiotherapy had normal gonadotropin levels and a normal-sized uterus on sonography; the ovary on the side that received radiotherapy was not seen in three of the 10 patients or was abnormally small (≤1.4 cm3) in two of the 10 patients compared with all normal ovaries in the postpubertal control group (p <.0001). One postpubertal patient with bilateral renal bed radiotherapy had normal ovaries and a normal-sized uterus. Significantly more patients in the postpubertal and ovarian failure radiotherapy group (5 [36%] of 14 patients) had one or both ovaries not seen than the control group (none [0%] of 25 patients; p = .0014). The uterus was significantly smaller than normal in three (23%) of the 13 patients in the postpubertal hemiabdomen and ovarian failure radiotherapy group versus none of the 25 patients in the postpubertal control group (p = .0339). CONCLUSION. Postpubertal female survivors of Wilm's tumor who underwent radiotherapy as children may have one or two small or absent ovaries and a small uterus that can be detected by sonography. The response of the uterus to hormone replacement therapy can also be assessed on sonography.

Original languageEnglish (US)
Pages (from-to)759-763
Number of pages5
JournalAmerican Journal of Roentgenology
Volume172
Issue number3
StatePublished - Mar 1999
Externally publishedYes

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Wilms Tumor
Survivors
Radiotherapy
Ovary
Uterus
Ultrasonography
Gonadotropins
Control Groups
Hormone Replacement Therapy
Abdomen

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Nussbaum Blask, A. R., Nicholson, H. S., Markle, B. M., Wechsler-Jentzch, K., O'Donnell, R., & Byrne, J. (1999). Sonographic detection of uterine and ovarian abnormalities in female survivors of Wilms' tumor treated with radiotherapy. American Journal of Roentgenology, 172(3), 759-763.

Sonographic detection of uterine and ovarian abnormalities in female survivors of Wilms' tumor treated with radiotherapy. / Nussbaum Blask, Anna R.; Nicholson, H. Stacy; Markle, Bruce M.; Wechsler-Jentzch, Kaethe; O'Donnell, Regina; Byrne, Julianne.

In: American Journal of Roentgenology, Vol. 172, No. 3, 03.1999, p. 759-763.

Research output: Contribution to journalArticle

Nussbaum Blask, AR, Nicholson, HS, Markle, BM, Wechsler-Jentzch, K, O'Donnell, R & Byrne, J 1999, 'Sonographic detection of uterine and ovarian abnormalities in female survivors of Wilms' tumor treated with radiotherapy', American Journal of Roentgenology, vol. 172, no. 3, pp. 759-763.
Nussbaum Blask AR, Nicholson HS, Markle BM, Wechsler-Jentzch K, O'Donnell R, Byrne J. Sonographic detection of uterine and ovarian abnormalities in female survivors of Wilms' tumor treated with radiotherapy. American Journal of Roentgenology. 1999 Mar;172(3):759-763.
Nussbaum Blask, Anna R. ; Nicholson, H. Stacy ; Markle, Bruce M. ; Wechsler-Jentzch, Kaethe ; O'Donnell, Regina ; Byrne, Julianne. / Sonographic detection of uterine and ovarian abnormalities in female survivors of Wilms' tumor treated with radiotherapy. In: American Journal of Roentgenology. 1999 ; Vol. 172, No. 3. pp. 759-763.
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abstract = "OBJECTIVE. The purpose of this study was to use sonography to evaluate the size of the ovaries and uterus in survivors of Wilms' tumor who underwent radiotherapy. SUBJECTS AND METHODS. Eighteen survivors of Wilms' tumor had their ovaries and uterus measured on sonography. Their ages at diagnosis and treatment ranged from 14 months to 6 years. Four girls were prepubertal (age, 5-9 years), 11 were postpubertal (age, 11-30 years), and three had primary ovarian failure (age, 15-23 years) at the time of imaging. Findings were compared with those of a control group of 25 prepubertal and 25 postpubertal girls and women. Gonadotropin levels were measured. RESULTS. Three patients who underwent whole abdomen radiotherapy had elevated levels of gonadotropin and primary ovarian failure. Neither ovary was seen in two of the three patients and both ovaries were abnormally small (≤1 cm3) in the third patient. The uterus was abnormally small (length, ≤4 cm) in all three of these patients even though two were being treated with hormone replacement therapy. Ten postpubertal patients who underwent hemiabdomen radiotherapy had normal gonadotropin levels and a normal-sized uterus on sonography; the ovary on the side that received radiotherapy was not seen in three of the 10 patients or was abnormally small (≤1.4 cm3) in two of the 10 patients compared with all normal ovaries in the postpubertal control group (p <.0001). One postpubertal patient with bilateral renal bed radiotherapy had normal ovaries and a normal-sized uterus. Significantly more patients in the postpubertal and ovarian failure radiotherapy group (5 [36{\%}] of 14 patients) had one or both ovaries not seen than the control group (none [0{\%}] of 25 patients; p = .0014). The uterus was significantly smaller than normal in three (23{\%}) of the 13 patients in the postpubertal hemiabdomen and ovarian failure radiotherapy group versus none of the 25 patients in the postpubertal control group (p = .0339). CONCLUSION. Postpubertal female survivors of Wilm's tumor who underwent radiotherapy as children may have one or two small or absent ovaries and a small uterus that can be detected by sonography. The response of the uterus to hormone replacement therapy can also be assessed on sonography.",
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AU - Nussbaum Blask, Anna R.

AU - Nicholson, H. Stacy

AU - Markle, Bruce M.

AU - Wechsler-Jentzch, Kaethe

AU - O'Donnell, Regina

AU - Byrne, Julianne

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N2 - OBJECTIVE. The purpose of this study was to use sonography to evaluate the size of the ovaries and uterus in survivors of Wilms' tumor who underwent radiotherapy. SUBJECTS AND METHODS. Eighteen survivors of Wilms' tumor had their ovaries and uterus measured on sonography. Their ages at diagnosis and treatment ranged from 14 months to 6 years. Four girls were prepubertal (age, 5-9 years), 11 were postpubertal (age, 11-30 years), and three had primary ovarian failure (age, 15-23 years) at the time of imaging. Findings were compared with those of a control group of 25 prepubertal and 25 postpubertal girls and women. Gonadotropin levels were measured. RESULTS. Three patients who underwent whole abdomen radiotherapy had elevated levels of gonadotropin and primary ovarian failure. Neither ovary was seen in two of the three patients and both ovaries were abnormally small (≤1 cm3) in the third patient. The uterus was abnormally small (length, ≤4 cm) in all three of these patients even though two were being treated with hormone replacement therapy. Ten postpubertal patients who underwent hemiabdomen radiotherapy had normal gonadotropin levels and a normal-sized uterus on sonography; the ovary on the side that received radiotherapy was not seen in three of the 10 patients or was abnormally small (≤1.4 cm3) in two of the 10 patients compared with all normal ovaries in the postpubertal control group (p <.0001). One postpubertal patient with bilateral renal bed radiotherapy had normal ovaries and a normal-sized uterus. Significantly more patients in the postpubertal and ovarian failure radiotherapy group (5 [36%] of 14 patients) had one or both ovaries not seen than the control group (none [0%] of 25 patients; p = .0014). The uterus was significantly smaller than normal in three (23%) of the 13 patients in the postpubertal hemiabdomen and ovarian failure radiotherapy group versus none of the 25 patients in the postpubertal control group (p = .0339). CONCLUSION. Postpubertal female survivors of Wilm's tumor who underwent radiotherapy as children may have one or two small or absent ovaries and a small uterus that can be detected by sonography. The response of the uterus to hormone replacement therapy can also be assessed on sonography.

AB - OBJECTIVE. The purpose of this study was to use sonography to evaluate the size of the ovaries and uterus in survivors of Wilms' tumor who underwent radiotherapy. SUBJECTS AND METHODS. Eighteen survivors of Wilms' tumor had their ovaries and uterus measured on sonography. Their ages at diagnosis and treatment ranged from 14 months to 6 years. Four girls were prepubertal (age, 5-9 years), 11 were postpubertal (age, 11-30 years), and three had primary ovarian failure (age, 15-23 years) at the time of imaging. Findings were compared with those of a control group of 25 prepubertal and 25 postpubertal girls and women. Gonadotropin levels were measured. RESULTS. Three patients who underwent whole abdomen radiotherapy had elevated levels of gonadotropin and primary ovarian failure. Neither ovary was seen in two of the three patients and both ovaries were abnormally small (≤1 cm3) in the third patient. The uterus was abnormally small (length, ≤4 cm) in all three of these patients even though two were being treated with hormone replacement therapy. Ten postpubertal patients who underwent hemiabdomen radiotherapy had normal gonadotropin levels and a normal-sized uterus on sonography; the ovary on the side that received radiotherapy was not seen in three of the 10 patients or was abnormally small (≤1.4 cm3) in two of the 10 patients compared with all normal ovaries in the postpubertal control group (p <.0001). One postpubertal patient with bilateral renal bed radiotherapy had normal ovaries and a normal-sized uterus. Significantly more patients in the postpubertal and ovarian failure radiotherapy group (5 [36%] of 14 patients) had one or both ovaries not seen than the control group (none [0%] of 25 patients; p = .0014). The uterus was significantly smaller than normal in three (23%) of the 13 patients in the postpubertal hemiabdomen and ovarian failure radiotherapy group versus none of the 25 patients in the postpubertal control group (p = .0339). CONCLUSION. Postpubertal female survivors of Wilm's tumor who underwent radiotherapy as children may have one or two small or absent ovaries and a small uterus that can be detected by sonography. The response of the uterus to hormone replacement therapy can also be assessed on sonography.

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