Ovarian tumorlike structures, biovular follicles, and binucleated oocytes in children

The occurrence of microscopic gonadoblastomalike and sex cord tumor with annular tubuleslike structures, biovular follicles, and binucleated oocytes was analyzed in 288 ovaries from 222 consecutive pediatric autopsies. Tumorlike structures were identified in 29% of the autopsies studied, biovular follicles were observed in 52% and binucleated oocytes in 19% These changes were not observed in 22 ovaries from adults. Sixteen cases with gonadoblastomalike structures were stained immunohistochemically for placental alkaline phosphatase and were nonreactive for this marker. These tumorlike structures and multiovular follicles are probably an expression of abnormal folliculogenesis that apparently disappears as the child matures and should not be confused with true neoplasms. Although these morphologic structures resemble the patterns of specific types of gonadal neoplasms, there is little evidence to suggest any potential for future neoplastic transformation..