8 YEAR OLD WITH ENLARGED OVARIES

My daughter is 8 years old & currently undergoing chemotherapy for Langerhans Cell Hisitocytosis with CNS involovement. Her current treatment plan is 5 consecutive days of chemo (Mon - Fri) Monday is Vincristine & ARA-C then Tues - Fri is just the ARA-C. Then she has 3 weeks off then the cycle is repeated again. She just finished her 3rd cycle last week ~ during this cycle of treatment she was complaining of lower quadrant pain, she vomitted about 7 times last Tuesday & had a low grade temp. The doctor decided to do a sonogram to just check the appendix, we got the results & she is now scheduled for MRI tomorrow because the sono showed that her ovaries are enlarged. They are concerned that the Histiocytosis could be affecting her ovaries now.
The report says :
"Using the sonographic window, the uterus is identified in prepubertal, appropriate for patient's age, and measures 2.9 cm in length. There are no gross uterine masses. There is no free fluid. Both ovaries are well demonstrated with physiologic follicles and the right ovary measuring 2.5 x 1.3 x 1.3 cm and the left 3.6 x 1.8 x 1.4 cm. The significance of there findings is unclear at this time. There is no dominant cyst or discrete mass."
Would anyone be able to give me any insight as to any other reasons her ovaries would be this big? What do you think this report means?  What size should an 8 yr old's ovaries be? Thank you very much for any information you can give to me. As I said her MRI is tomorrow then we see the doctor at the end of the week.
Teresa

[Elaine Brown, MD]

Hi!
I have an 8 year old daughter too, and am so sorry that you are having to go through this with her, and more sorry for her!  You sound very brave and proactive and I'm sure she is lucky to have you on her team.

You mention that she has CNS involvement, and I wonder if that includes her pituitary gland.  If so, it could be possible that her pituitary is producing FSH or LH that is stimulating her ovaries.  An endocrinologist might be a good person to consult if there is not already someone on the team.

Another possibility might be infiltration of the ovaries by the histiocytes, but I think this is less likely because there are developing follicles in the ovaries that are contributing to the enlargement.

Some blood tests such as LH FSH and estradiol might be helpful.

Good luck!
My heart goes out to you two!
Dr B