Ovarian gonadoblastoma with dysgerminoma in a young girl. Formalinfixed, paraffinembedded cell blocks of 33 cases of dysgerminoma including 2 cases of gonadoblastoma associated with dysgerminoma and 3 cases of metastatic dysgerminoma, and 111 cases of nondysgerminomatous neoplasms. One patient case 3 had a simultaneous pregnancy and dysgerminoma, and the pregnancy may have accounted for the positive urine test for hcg. Dysgerminoma developed in 3 phenotypic female patients with 46 xy pure gonadal dysgenesis. Dysgerminomas of the ovary are rare germ cell tumors. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. Although there are approximately 200 cases reported in the literature up to 1939 1, the dysgerminoma is a relatively uncommon ovarian neoplasm, its frequency being variously reported as 3 to 10 per cent of primary malignant tumors of the ovary 1, 5, 6, 7. Our understanding of dysgerminoma has improved, so that treatment schemes with better. The neoplasms are grayyellow and firm, contain foci of necrosis and hemorrhage, and tend to be encapsulated. Formalinfixed, paraffinembedded cell blocks of 33 cases of dysgerminoma including 2 cases of gonadoblastoma associated with dysgerminoma and 3 cases of metastatic dysgerminoma, and 111 cases of. Advanced ovarian dysgerminoma infiltrating both ovaries and. Of the 10 patients in stage i, 2 patients underwent a unilateral salpingooophorectomy uso and were kept under observation without any adjuvant therapy, while the remaining patients received adjuvant treatment. A case of dysgerminoma of the right ovary is reported in a twentyseven year old white female, who had been in good health until two weeks before entry into the hospital, with the symptoms of abdominal distention, pulling sensation in both flanks, backache and pain radiating to both shoulders. Pdf ovarian dysgerminoma od is one of the most common malignant tumours of the ovarian germ.
The other complications of ovarian dysgerminoma may include. Dysgerminoma is a malignant germ cell tumor of the ovary believed to arise from primordial germ cells, similar to the testicular seminoma counterpart. Pdf ovarian dysgerminoma disgerminom jajnika researchgate. On examination, there was a hard, nontender 12 cm x 10 cm lump occupying almost the whole left lumbar region extending into the left hypochondrial region. The ovary is an organ found in the female reproductive system that produces an ovum. The findings are indicative of true hermaphroditism.
Ovarian germ cell tumor treatment ovarian teratoma treatment. The biopsy from other ovary, peritoneal surface, omentum and paraarotic lymph nodes were negative for malignancy. Ovarian gonadoblastoma with dysgerminoma in a young girl with. There have been several published reports of ovarian germ cell cancers affecting more than one family member.
On germinal ovarian cancer, dysgerminoma is most frequently relately with nodal metastasis. The patient was discharged from the hospital on september 11, 1946, and continued xray therapy on an outpatient basis. Their patient received 10 courses of chemotherapy and was free. Ninety percent occur in people younger than 30 years, and 75% occur in the second and third. The dual cell type and other characteristics are typical of dysgerminoma of ovary. Dysgerminoma is the most frequent malignant germ cell tumor of the ovary. Ovarian dysgermination is most common maligant germ cell tumor gct of ovary. Pdf ovarian dysgerminomas are rare entity and account for only about 2%of.
Management of female malignant ovarian germ cell tumours 1. This is encapsulated with smooth or bossellated external surface. Dysgerminoma usually occurs in adolescence and early adult life. Her left ovary was the size of a football the normal size is more like an almond. Hcg more commonly points to the possibility of an ectopic pregnancy rather than an ovarian malignancy. Ovarian germ cell tumor is a disease in which malignant cells form in the germ egg cells of the ovary. Experience with adjuvant chemotherapy is limited, but considering the effectiveness of chemotherapy in tumors other than dysgerminoma and its effectiveness in advancedstage dysgerminoma, adjuvant chemotherapy is likely to be effective and to allow recovery of reproductive potential in patients with an intact ovary, fallopian tube, and uterus. Management of female malignant ovarian germ cell tumours. If dysgerminoma is limited to one ovary, surgery to remove that ovary and the fallopian tube on the same side might be the only treatment needed, without chemo after surgery. Dysgerminomas are the most common malignant gcts of the ovary, comprising approximately. What is the pathophysiology of dysgerminoma of the ovary.
Dysgerminoma medigoo health tests and free medical. Dysgerminoma in three patients with swyer syndrome world. Epidemiology they are rare ovarian tumors that occ. The ovaries also secrete hormones that play a role in the menstrual cycle and fertility. Ovarian dysgerminoma lazebnik 2009 journal of ultrasound in. Cut surface will be fleshy and solid, which is greywhite to yellowish. Dysgerminoma presentation solid, lobulated, and can be large 15% associated with mct associated with gonadal dysgenesis and gonadoblastoma high growth fraction, lymphatic spread tumor markers ldh, placental alkaline phosphatase survival overall 86% stage i 90%. It is usually seen in patients 30 years of age, but can be seen both in premenopausal and postmenopausal women, albeit rarely. Kit gene mutation and amplification in dysgerminoma of the.
Emil novak, who were requested to examine these tissues, expressed a similar opinion. She had no other treatment but her ca125 is and was being monitored. Ovarian dysgerminoma is a rare malignant ovarian germ cell tumor with its peak incidence in young women. Dysgerminoma occurs in both ovaries in 10% of patients and, in a further 10%, there is microscopic tumor in the other ovary. A biopsy should be performed on the contralateral ovary at the time of surgery if the ovary is enlarged or appears abnormal. The 5year relapsefree survival rates were 91% in patients with stages ia, ib, and ic. Dysgerminoma is the most common type of malignant germ cell tumor of the ovary. Germ cell tumors arise from primordial germ cells of the ovary and the testis. Dysgerminoma ovary this is the ovarian counterpart of seminoma in males. These are uncommon neoplasms that correspond to less than 1% of all malignant ovarian tumors. Dysgerminomas are tumors originating within the primordial ovarian germ cells.
Dysgerminomas are malignant germ cell tumors of the ovary that most commonly occur in the adolescent population. Ovarian dysgerminoma presenting with complications like torsion is a rare entity in the pediatric age group. Historically, a wedge biopsy of the contralateral ovary was recommended to rule out microscopic spread in that ovary. There is an ovary from latin ovarium, meaning egg, nut found on each side of the body. One percent of all ovarian cancers are dysgerminoma cases. Ovarian dysgerminomas are a type of germ cell tumor of the ovary. All patients presented first with abdominopelvic mass. Dysgerminoma definition of dysgerminoma by medical. Malignant gcts are classified into several subgroups, the most common of which, dysgerminoma, is the female counterpart of testicular seminoma and comprises 1% to 2% of all malignant ovarian tumors. Dysgerminoma disease staged below ia ie, confined within the capsule of only 1 ovary is best treated with simple unilateral salpingooophorectomy. They are the most common malignant germ cell tumors of the ovary and are thought to account for 1% of all ovarian neoplasms 5. Preoperative elevation of tumor markers is significantly related to poor prognosis for progressionfree survival pfs 4. Features favoring dysgerminoma include presence of fibrous septae and squared off nuclei. Ovarian dysgerminoma medigoo health medical tests and.
Ovarian germ cell tumor dysgerminoma cleveland clinic. Microscopic sections of the ovarian tissue were examined by dr. Ovarian dysgerminoma associated with pregnancy performed. Proliferative endometrium was found lining the small uterus. The controversy on the use of irradiation in stage. Hi, i just wanted to say that my stepdaughter was diagnosed at 16 with ovarian dysgerminoma. Pure dysgerminoma of the ovary is rare accounting for 0. Ovarian dysgerminoma is a common malignant tumor that comprises of ovarian germ cells. Background female malignant ovarian germ cell tumours mogcts are rare, but early diagnosis and multiagent chemotherapy are 1associated with high cure rates of 85. Dysgerminoma, the ovarian counterpart of seminoma, is the most common type of malignant ovarian germ cell tumor.
A dysgerminoma is a tumor of the ovary that is composed of primitive, undifferentiated germ cells. Histomorphology identical to that of testicular seminoma. An impression of germ cell tumor of ovary, dysgerminoma was made. The role of kit mutation and amplification in the development of dysgerminoma is not currently established. Dysgerminoma is morphologically and immunophenotypically similar to testicular seminoma. Dysgerminoma of the ovary with widespread metastases radiology.
There may be a rapid growth of the tumor which may invade into surrounding tissue causing tissue damage. Jun 23, 2007 dysgerminoma is the most common malignant germ cell tumor of the ovary. To the authors knowledge, this is the first reported case of dysgerminoma occurring in a phenotypic female. The occurrence of dysgerminoma and other tumors in association with various forms of gonadal dysgenesis is discussed. It is diagnosed by physical examination and imaging methods and is treated by salpingooophorectomy, radiation, and chemotherapy.
The histopathology was suggestive of dysgerminoma of the left ovary, and the patient subsequently received 4 cycles of paclitaxel and carboplatin and 1 cycle of paclitaxel and cisplatin. Clinical analysis of 57 patients with ovarian dysgerminoma. With median followup of 54 months, the 5year diseasefree survival dfs and. The main complication of ovarian dysgerminoma is infertility due to invasion of ovary by tumor or due to side effect of chemotherapy. Read more about symptoms, diagnosis, treatment, complications, causes.
Signs of ovarian germ cell tumor are swelling of the abdomen or vaginal bleeding after menopause tests that examine the ovaries, pelvic area, blood, and ovarian tissue are used to detect find and diagnose ovarian germ cell tumor. In studies of young women who received platinumbased chemotherapy for ovarian germ cell tumors gcts, 62 87% of 71 resumed regular menstrual function and 24 of these women delivered 37 children after chemotherapy. Results the patient underwent radical surgery for an advanced dysgerminoma, 20 cm in length, that compromised the contralateral ovary and sigmoid. The purpose of this study was to analyze alterations of the kit gene in a large series of dysgerminomas and correlate the findings with clinicopathological. Abdominal pain, abdominal distention, and the presence of a palpable mass are common symptoms at presentation. Dysgerminoma of the ovary, journal of surgical oncology. In 1931, meyer first applied the term dysgerminoma to the ovarian counterpart of the testicular seminoma. Kit gene mutation and amplification in dysgerminoma of the ovary. It is important that therapy of ovarian dysgerminoma be optimized because of the young age of women affected and the threat that therapy may pose to fertility. Amongst these tumours there are some groups, characterized by similar clinical, histological, and histogenic features, which stand out. Jan 23, 2020 additionally, note that the contralateral ovary may be involved in 510% of patients who appear to have stage ia disease. A malignant neoplasm of the ovary counterpart of seminoma of the testis, composed of undifferentiated gonadal germinal cells and occurring more frequently in patients less than 20 years of age.
Surgery followed by irradiation has resulted in excellent cure rates in early stages of this disease. The efficacy of chemotherapy allows conservative surgery sparing fertility. Dec 14, 2018 the main complication of ovarian dysgerminoma is infertility due to invasion of ovary by tumor or due to side effect of chemotherapy. Dec 23, 2019 a dysgerminoma is a tumor of the ovary that is composed of primitive, undifferentiated germ cells.
This is the most common malignant gct and represents 35% of all ovarian malignancies. This approach requires close followup so that if the cancer comes back it can be found early and treated. The patient was first operated for dysgerminoma on the left ovary and an ovariectomy was performed. Mogcts, which include dysgerminomas, immature teratomas, embryonal tumours and endodermal sinus. Advanced ovarian dysgerminoma infiltrating both ovaries. Dysgerminoma is an ovarian germ cell tumor occurring more frequently among young women. Dysgerminoma its not about the bike incidence 112% of ovarian tumors 335% of ovarian malignancies 40% of all gct40% of all gct peak incidence age 19 67% sta67% stage ia 1015% bilaterality 20% in 20% in normal appearing opposite. This study examines the expression of oct4 in both dysgerminoma and nondysgerminomatous neoplasms involving the ovary. The mass mostly occupied the posterior pelvic cavity and impacted into the douglas pouch as shown in fig. Summary a case of dysgerminoma of the right ovary is reported in a twentyseven year old white female, who had been. Hugh jeter, who made a diagnosis of malignant dysgerminoma. The major challenge with dysgerminoma, the commonest malignant variety of germ cell tumor, is that they predominantly affect young women.
Immunohistochemistry was suggested for confirmation and to rule out mixed tumor variant. This malignancy can be associated with pure gonadal dysgenesis or swyer syndrome, mixed gonadal dysgenesis and partial gonadal dysgenesis. Dysgerminoma medical definition merriamwebster medical. Depending on the figo stage at presentation the prognosis of dysgerminomas after surgical treatment, adjuvant chemotherapy, and radiotherapy is promising. Their patient received 10 courses of chemotherapy and was free of relapse after 2 years of surgery. Dysgerminoma definition of dysgerminoma by medical dictionary. Eighty percent of these maligant tumor cases occur during 2nd and 3rd age decades and their mean and median occur in late teens and early twenties. An ovarian dysgerminoma is a rare, malignant tumor occurring in young women, accounting for 1% to 2% of all primary ovarian neoplasms.
Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Dysgerminoma is an uncommon tumor that accounts for 12% of primary ovarian neoplasms and for 35% of ovarian malignancies. In a study by weinberg et al, 40 women with malignant ovarian gcts were followed for reproductive outcomes. Thickening of the fallopian tube is more suggestive of lymphoma int j gynecol pathol 2008. Ovarian dysgerminoma description, causes and risk factors. Sheets or nests of large, uniform polygonal cells with clear.
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