Baby starts menstruating at four months, survives rare ovarian cancer at age two - Read full story

A baby girl who started menstruating at the age of four months has survived sex cord stromal tumors, described by doctors as ‘rare ovarian cancer.’

Experts say that sex cord stromal tumors is a rare type of cancer that forms in the tissues that support the ovaries or testes.

“These tumors may release sex hormones, and it is also called sex cord tumor and sex cord-gonadal stromal tumor,” doctors say.

Baby Bibian developed ovarian cancer when she was four months old, her mother, Faustine Andeso, tells The Standard at their Likuyani home in Kakamega County, Kenya.

Bibian, her parents’ first child, was born on April 16, 2019. “She was born weighing 4.2kg. She looked healthy,” her mother recalls.

Things started assuming fearful dimensions when the baby girl turned four months old and started manifesting symptoms of puberty as she developed acne.

Her breasts became enlarged, and pubic hair also began to sprout. About a month after the symptoms appeared, Bibian started to bleed from the vagina.

“The bleeding lasted five days,” says her mother of what is the standard bleeding duration for a menstruating female.

Faustine took her daughter to hospital.

“She was treated for blood infection and given antibiotics,” the mother says. However, the situation didn’t improve.

The following month, she bled again, “like she was having menses,” Bibian’s mother says, recalling the beginning of a hard-fought battle to save her baby.

By now abandoned by her husband whom she had married on March 24, 2018, Faustine says that she moved from one hospital to another searching for proper diagnosis and treatment, but nothing much came of it.

She narrates how she borrowed money from friends, families and church to be able to pay the mounting medical bills.

In December 2019, she travelled up country to mark holiday festivities with her mother.

“At some point, my mother was bathing Bibian and she noticed that the girl was bloated. She advised me to take her to hospital. I attributed the bloating to her big body because I am also big bodied,” Faustine says.

They went to Likuyani Sub-County Hospital, Kenya, where medics prescribed antibiotics and other medicines to treat bloating and indigestion.

“But my daughter’s symptoms got worse. She now had no appetite, was breathing heavily and could not stomach food,” Faustine says. So, they went back to the hospital where Bibian was asked to undergo an ultrasound.

Results showed that Bibian’s abdomen was filled with fluids. The patient was referred to Moi Teaching and Referral Hospital. Faustine heeded the advice on December 26, 2019, and Baby Bibian was admitted and a fresh round of tests and scans were ordered.

“Around 10am on January 7, 2020, we were in the ward when I saw many doctors come in. One of them – their leader – called out my name and I responded.

“He then explained that Bibian had a growth in her reproductive system. It was the growth that was producing fluids. He recommended surgery immediately.

“My heart sank. I feared that she wouldn’t make it through surgery,” Faustine recalls.

The lead doctor was Elly Odongo, an obstetrician and gynaecologist and the head of gynaecological oncology at MTRH.

“Bibian’s case was brought to my attention in early 2020. From tests, the girl had a type of ovarian cancer known as sex cord stromal tumour,” Dr. Odongo says.

Bibian’s cancer was at stage 2 when she was taken to MTRH. Odongo advised parents of young girls to be on the lookout for symptoms that mimic puberty.

“Cancer? Of the ovaries? In a baby? I thought this disease only affects women of reproductive age,” Bibian’s mother recalls.

Dr. Odongo told Bibian’s mother that the tumour was functional, meaning, it was producing hormones – oestrogen and testosterone; noting that it was the reason the baby presented with symptoms of a child entering puberty.

“The blood she was shedding is equivalent to menstruation in a woman of reproductive age. Of course, in an eight-month-old, this means something is wrong,” Odongo says.

The following day, Odongo and his team operated on Bibian and removed the tumours. The surgery was followed by chemotherapy – which Fausine says was brutal on Baby Bibian.

Now at age two years and five months, Bibian has been declared cancer-free. She, however, needs immune boosters and multivitamin supplements to help her fight common infections as chemotherapy has affected her immunity.

Faustino states that her daughter’s battle with cancer has cost her friendships, her (old) job, peace of mind, and, worst of all, her marriage.

What is ovarian cancer in babies all about?

Ovarian cancer in babies or ovarian tumors in children is a rare type of cancer that usually forms in infants, young girls, and adolescents on one or both ovaries. Ovaries are organs that store and release eggs and produce female hormones.

Ovarian tumors account for one percent of all malignant tumors found in children between birth and age 17. In girls younger than eight, four out of five ovarian tumors are benign (noncancerous).

Ovarian tumors are different from ovarian cysts. Tumors are solid masses of tissue, while cysts contain fluid, tissues, or other materials.

Some ovarian cysts can become malignant (cancerous). Non-functional cysts, which do not go away on their own and are not associated with a woman producing an egg each month, can become malignant.

In children and adolescents, ovarian tumors have a much higher cure rate than adult forms of ovarian cancer.

Children with benign (noncancerous) ovarian tumors receive care from specialists at Boston Children’s Gynecology Program.

Causes of Ovarian Tumors in children

Doctors do not completely understand the cause of most ovarian tumors. While ovarian tumors often occur with no known cause, there are some risk factors, including:

  • Inherited gene mutations
  • Breast cancer gene 1 (BRCA1)
  • Breast cancer gene 2 (BRCA2)
  • Family history of ovarian cancer
  • Previous cancer diagnosis

Symptoms

Ovarian tumors sometimes don’t produce symptoms. Their symptoms can also depend on the tumor’s size and location.

Ovarian tumor symptoms may include:

  • A feeling of pressure or fullness in the abdomen or pelvis
  • A firm, painless swelling in the lower abdomen
  • Frequent urination or retention of urine
  • Persistent abdominal pain
  • Nausea
  • Vomiting

Among girls younger than 8, an ovarian tumor or cyst may cause secretions of estrogen, producing:

  • Breast enlargement
  • Pubic hair
  • Vaginal discharge or bleeding
  • Abnormal menstrual bleeding

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