Ovarian germ cell tumors

Overview of ovarian germ cell tumors

Ovarian Germ Cell Tumors

Dysgerminoma under high magnification

Ovarian germ cell tumors are a diverse group of neoplasms that originate from the germ cells of the ovary. These tumors are relatively rare, accounting for approximately 2-3% of all ovarian cancers. They primarily affect young women and adolescents, often presenting during the reproductive years.

Classification

Ovarian germ cell tumors are classified into several types based on their histological characteristics:

Dysgerminoma

Dysgerminomas are the most common type of malignant germ cell tumor, representing about 30-40% of all ovarian germ cell tumors. They are analogous to seminomas in males and are characterized by their sensitivity to radiation therapy.

Immature Teratoma

Immature teratoma under high magnification

Immature teratomas contain immature or embryonic tissues and are graded based on the amount of immature neural tissue present. They are more aggressive than mature teratomas and require careful management.

Yolk Sac Tumor

Yolk sac tumor under intermediate magnification

Also known as endodermal sinus tumors, yolk sac tumors are highly malignant and often secrete alpha-fetoprotein (AFP), which can be used as a tumor marker for diagnosis and monitoring.

Choriocarcinoma

Choriocarcinoma metastasis to lung under high magnification

Ovarian choriocarcinomas are rare and aggressive tumors that can produce human chorionic gonadotropin (hCG). They are often associated with gestational trophoblastic disease but can occur as pure germ cell tumors.

Mature Teratoma

Mature teratomas, also known as dermoid cysts, are benign tumors that contain well-differentiated tissues from all three germ layers. They are the most common type of germ cell tumor and are often discovered incidentally.

Clinical Presentation

Patients with ovarian germ cell tumors may present with abdominal pain, a palpable mass, or symptoms related to tumor rupture or torsion. Hormonal activity of the tumor can also lead to precocious puberty or menstrual irregularities.

Diagnosis

Diagnosis of ovarian germ cell tumors involves a combination of imaging studies, serum tumor markers, and histopathological examination. Ultrasound and MRI are commonly used imaging modalities, while serum markers such as AFP, hCG, and lactate dehydrogenase (LDH) aid in diagnosis and monitoring.

Treatment

Diagram of ovarian cancer treatment

The treatment of ovarian germ cell tumors typically involves surgical resection, often followed by chemotherapy. The specific regimen depends on the type and stage of the tumor. Fertility-sparing surgery is often considered in young patients.

Prognosis

The prognosis for patients with ovarian germ cell tumors is generally favorable, especially for those with early-stage disease. Advances in chemotherapy have significantly improved survival rates.

Related Pages

• Ovarian cancer
• Germ cell tumor
• Teratoma
• Choriocarcinoma