Sex Cord Stromal Tumors in Children and Adolescents: A First Report by The South African Children's Cancer Study Group (1990-2015)

J Pediatr Hematol Oncol. 2021 Jul 1;43(5):e619-e624. doi: 10.1097/MPH.0000000000002076.


Objectives: Pediatric sex cord stromal tumors (SCSTs) are extremely rare and there are no reported data from Africa. The authors evaluated the outcomes of children and adolescents with biopsy-proven SCSTs in preparation for the introduction of a national protocol.

Materials and methods: Retrospective data were collated from 9 South African pediatric oncology units from January 1990 to December 2015. Kaplan-Meier analysis was performed to estimate overall survival (OS) and event-free survival.

Results: Twenty-three patients were diagnosed with SCSTs, 3 male and 20 female individuals, during the study period. Histologies included 1 thecoma, 9 Sertoli-Leydig cell tumors, and 13 juvenile granulosa cell tumors. Stage I tumors predominated (n=14; 60.9%), with 2 stage II (8.7%), 5 stage III (21.7%), and 2 stage IV tumors (8.7%). The upfront resection rate was 91.3% with no reported surgical morbidity or mortality and an OS of 82.1%. Chemotherapy approaches were not standardized. Most children (81.8%), except 2, had recognized platinum-based regimens. Chemotherapy-related toxicity was minimal and acceptable. Assessment of glomerular filtration rate and audiology assessments were infrequent and not standardized. Three patients were lost to follow-up.

Conclusions: Although the numbers in this cohort are small, this study represents the first national cohort in Africa. The 5-year OS of 82.1% was encouraging. Standardized management of rare tumors like SCSTs is critical to improve ensure OS and address potential long-term sequelae.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Africa South of the Sahara / epidemiology
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Child
  • Child, Preschool
  • Cisplatin / administration & dosage
  • Cisplatin / therapeutic use
  • Female
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / epidemiology
  • Prognosis
  • Retrospective Studies
  • Sex Cord-Gonadal Stromal Tumors / diagnosis*
  • Sex Cord-Gonadal Stromal Tumors / drug therapy*
  • Sex Cord-Gonadal Stromal Tumors / epidemiology
  • Testicular Neoplasms / diagnosis*
  • Testicular Neoplasms / drug therapy*
  • Testicular Neoplasms / epidemiology


  • Antineoplastic Agents
  • Cisplatin