Germ cell and nonepithelial ovarian cancer oncohema key. Disease progression dosage of tumor markers hcg, ldh and. Types of germ cell neoplasms frequency malignant ogcts ovarian tumor markers ovary, fallopian tube, primary peritoneal carcinoma tnm, 8th ed carcinoid symptoms related topics. Feb 10, 2016 terms germ cells a germ cell is any biological cell that gives rise to the gametes of an organism that reproduces sexually. Analysis of germ cell tumors of ovary in a tertiary care. Although germ cell tumors of the ovary are morphologically similar to testicular germ cell tumors, they may not necessarily have an identical origin.
Mar 16, 2020 home gynecologic ovary germ cell tumors of ovary germ cell tumors gct originate from primordial germ cells and make up 30% of all ovarian tumors. Pdf germ cell tumors of the ovary an update researchgate. More than half of mediastinal germ cell tumors are mature teratomas. Ovarian cancer is a cancer that forms in or on an ovary. As with epithelial ovarian cancers, it is a good idea to consult with a gynecologic oncologist for treating malignant germ cell tumors. There are three main types of ovarian tumors click on type diagnosed. Of 63 patients felt to have an intact tumor capsule by the surgeon, pathologic results of capsular integrity were table 1. A biopsy is the removal of a small amount of tissue for examination under a microscope. Ovarian germ cell tumors usually occur in teenage girls or young women and most often affect just one ovary. Handbook for children with germ cell tumors american pediatric. Malignant mixed germ cell tumor of the ovary radiology. These are uncommon neoplasms that correspond to less than 1% of all malignant ovarian tumors. Germ cell tumor gct, dysgerminoma, metastatic ovarian cancer.
Germ cell tumors can arise from the ovary or from other locations of the body due to germ cell migration. Histologically they are classified as dysgerminoma, yolk sac tumor, embryonal carcinoma, polyembryoma, nongestational. Germ cell tumours tend to affect only one ovary, and most are curable even if diagnosed at an advanced stage. They include malignancies of germ cell origin, sexcordstromal cell origin, metastatic carcinomas to the ovary, and a variety of extremely rare ovarian cancers, for example, sarcomas and lipoid cell tumors. Epithelial ovarian tumors are derived from the cells on the surface of the ovary. Prognostic factors include stage, amount of residual tumor, histologic type and raised tumor markers. Germ cell tumors can spread metastasize to other parts of the body. Germ cell a germ cell is any biological cell that gives rise to the gametes of an organism that reproduces sexually. Dysgerminoma is a malignant germ cell tumor of the ovary believed to arise from primordial germ cells, similar to the testicular seminoma counterpart.
Histologically they are classified as dysgerminoma, yolk sac tumor, embryonal carcinoma, polyembryoma, nongestational choriocarcinoma, and teratomas and mixed cell tumors. Ovarian germ cell tumor dysgerminoma cleveland clinic. Ovarian germ cell tumor is a disease in which malignant cells form in the germ egg cells of the ovary. Gcts that originate outside the gonads may be birth defects resulting from errors during development of the embryo. For patients with early stage disease, cure rates approach 100%, while for those with advancedstage disease are at least 75%. The documents contained in this web site are presented for information purposes only. Below are the links to the authors original submitted files for images. These tumors are most commonly found in the ovary, testes and sacrococcygeal areas tail bone, or distal end of spinal column. Ovarian germ cell tumor treatment ovarian teratoma treatment. All cases of ovarian tumors during the period from may 20 to june 2015 were retrieved from the record files and analyzed.
Germ cell tumors of the ovary are uncommon, but aggressive, tumors, which. Although the content of pdq documents can be used freely as text, it cannot be. Talerman a 1975 the incidence of yolk sac tumor endodermal sinus tumor elements in germ cell tumors of the testis in adults. Terms germ cells a germ cell is any biological cell that gives rise to the gametes of an organism that reproduces sexually. Malignant germ cell cancers of the ovary include dysgerminomas and nondysgerminomas, which include immature teratomas, embryonal cell carcinoma, yolk sac tumors, primary ovarian nongestational choriocarcinomas. An attempt is made to remove all germ cell tumors with surgery. Now in april of 2009 the doctor thought it had come back so i decided to get a 2nd opinion and he did a pet scan and it came back clear. Endodermal sinus tumor or yolk sac tumors endodermal sinus tumor or yolk sac tumors are germ cell tumors that are most often malignant, but may also be benign. These tumors are most commonly found in the ovary, testes, and sacrococcygeal areas tail bone, or distal end of spinal column. Symptoms become more noticeable as the cancer progresses. Stage 4 the tumor has spread to other areas of the body. They are asymptomatic until complications such as torsion or rupture arise.
Women with benign noncancerous germ cell tumors such as mature teratomas dermoid cysts are cured by removing the part of the ovary that has the tumor ovarian cystectomy or by removing the entire ovary. If disease appears to be limited to the ovaries or pelvis, a pelvic and paraaortic lymphadenectomy should. This is the most common form of ovarian cancer and occurs primarily in adults. Extracranial germ cell tumor what is a germ cell tumor.
The concept of germ cell tumors as a specific group of. Kurman rj, norris hj 1976 malignant mixed germ cell tumors of the ovary. A germcell tumor gct is a neoplasm derived from germ cells. Ovarian germ cell tumor is a disease in which malignant cancer cells form in the germ egg cells of the ovary. An unknown percentage of malignant germ cell tumors reported in phenotypic women may, in fact, represent mtgcts seminomas, embryonal carcinomas, mixed germ cell tumors, as they may have originated from the malignant germ cell component of gonadoblatomas present in dysgenetic gonads of patients with an unrecognized y. Malignant gct make up 3% and 20% of all ovarian cancers in western countries and asianafrican countries respectively.
In the ovary it is not as visible and the tumor may grow very large before being noticed. Germ cell tumors of the ovary radiology reference article. Germ cell tumors begin in the reproductive cells egg or sperm of the body. Yolk sac or germ cell tumor a yolk sac tumor is a rare, malignant tumor of cells that line the yolk sac of the embryo. Mixed germ cell malignancies of the ovary contain two or more elements of the tumors described above. It results in abnormal cells that have the ability to invade or spread to other parts of the body. They represent 4050% of all benign ovarian neoplasms. Diseasefree survival rates in these patients are quite high and recurrences can be managed with secondline chemotherapy. About 23% of all ovarian cancers are germ cell tumors. Postoperative vac therapy, however, did not appear to be effective in patients with unresectable or incompletely resected germ cell tumors of the ovary. Germ cell tumor of the ovary is an eminently treatable disease and selected patients can be managed with fertilitypreserving surgery. Malignant germ cell cancers of the ovary include dysgerminomas and nondysgerminomas, which include immature teratomas, embryonal cell carcinoma, yolk sac tumors, primary ovarian nongestational choriocarcinomas, polyembryoma, and mixed germ cell tumors.
Fifteen of 22 patients 68% with incompletely resected germ cell tumors failed vac therapy, including 4 of 7 with pure endodermal sinus tumor. Germ cell tumors health encyclopedia university of. Ovarian germ cell tumors from routine material and expert consultation files at san cecilio university hospital, granada, spain. Ovarian germ cell tumors usually occur in teenage girls or. Surgical staging is the first step in the management of ovarian germ cell cancer. Mature cystic teratomas comprise about 1520% of germ cell tumors of the ovary 1,5,6. Ovarian germ cell tumors treatment options include surgery, chemotherapy, and. Outcome and staging evaluation in malignant germ cell tumors.
Staging includes peritoneal cytology, hysterectomy, bilateral salpingooophorectomy, omentectomy, and exploration of peritoneal surfaces and diaphragm with biopsies. Table 1 subtypes and characteristics of ovarian germ cell tumours data derived from rice, 1999 and john hopkins pathology, 2001. More than 95% of gct are benign dermoid cysts mature cystic teratomas. Stages of ovarian germ cell tumors after ovarian germ cell tumor has been diagnosed, tests are done to find out if cancer cells have spread within the ovary or to other parts of the body. A germ cell tumor gct is a neoplasm derived from germ cells. When found in the ovaries and testes, theyre often very aggressive, malignant, and can spread.
There are many kinds of germ cell tumors and only some. These neoplasms comprise approximately 20 to 25 percent of ovarian neoplasms overall, but account for only an approximate 5 percent of all malignant ovarian neoplasms. However, these tumours are rare, occurring annually in approximately 3. A malignant mixed germ cell tumor of the ovary is a subtype of ovarian germ cell tumor. Germ cell tumors of the ovary are presumed to derive from the pathogenic transformation of ovarian germ cells at different stages of development. Includes all primary epithelial borderline tumors and carcinomas, carcinosarcoma, malignant germ cell tumors, and. Ovarian germ cell tumors ogcts are derived from primordial germ cells of the. The results of earlier medical tests in addition to a physical examination, the following tests may be used to diagnose a germ cell tumor. Cell tumor the mediastinum is the most common site of extragonadal germ cell tumors 11, constituting 5070% of all extragonadal germ cell tumors. Apr 10, 2018 germ cell tumor of the ovary is an eminently treatable disease and selected patients can be managed with fertilitypreserving surgery. The ovaries make a womans eggs and female hormones. Most ovarian cancers are a type called epithelial cancer. Germ cell tumors start in the ovarian cells that produce eggs. For most types and stages of germ cell cancers most types and stages of germ cell cancers of the ovary are treated the same way, with surgery and chemotherapy chemo.
Ovarian germ cell tumors treatment pdqpatient version. If you just found out that you or your child has a germ cell tumor, you may have a lot of questions about what it means and what comes next. Ovarian germ cell tumours gcts account for approximately five percent of all ovarian cancers and are most commonly diagnosed in young women. Management of female malignant ovarian germ cell tumours. Malignant germ cell cancers of the ovary include dysgerminomas and nondysgerminomas, which include immature teratomas, embryonal cell carcinoma, yolk sac tumors, primary ovarian nongestational choriocarcinomas, polyembryoma, and mixed germ cell tumors 1. Germ cell tumors include tumors which arise from the ovum and its precursor germ cells. Nonepithelial malignancies of the ovary account for approximately 10% of all ovarian. Steroid cell tumors of the ovary are rare sexcord neoplasms which account for less than 0. Germ cells normally occur inside the gonads ovary and testis. Nonspecific mesenchyme metastatic tumors 5070% 1520% 510% 510% 510%.
Germ cell tumors atlas of genetics and cytogenetics. Compared with epithelial ovarian cancers, nonepithelial ovarian tumors are uncommon. So why would the germ cell tumors be in the ovaries and not the fallopian tube or the endometrium. Ovarian germcell tumors represent 1520% of all ovarian tumors, 3% of which are malignant. This can lead to abdominal pain, abdominal swelling. Endodermal sinus tumor or yolk sac tumors are germ cell tumors that are most often malignant, but may also be benign. The chemotherapy chemo used to treat germ cell tumors depends on the location of the tumor, the type of tumor and the stage of disease. In adults, extragonadal germ cell tumors account for 15% of primary anterior mediastinal tumors 12. Malignant germ cell tumor of ovary is a rare ovarian cancer see this term arising from germ. In children and adolescents, up to 60% of ovarian tumors can be of germ cell origin. Ovarian stromal tumors fibroma granulosa cell tumors inhibin, ca125 sertolileydig tumors caca125.
Some studies have found that size and histology were the major factors determining prognosis for patients with malignant mixed germ cell tumors of the ovary. Other symptoms can lead to abnormal vaginal bleeding or precocious puberty. In fact, eighty percent of preadolescent malignant ovarian tumors are gcts. A two year retrospective study muktanjalee deka1, chandan jyoti saikia2. Mogcts, which include dysgerminomas, immature teratomas, embryonal tumours and endodermal sinus.
Clinical characteristics of welldifferentiated neuroendocrine carcinoid tumors arising in the gastrointestinal and. As a baby grows in the uterus, cells form the reproductive system, including eggs in the ovary and sperm in the testes. Germ cells tumors of the ovary account for approximately 1520% of all ovarian tumors. Germ cell and stromal tumors of the ovary fred ueland, md university of kentucky gynecologic oncology. Germ cell tumors gct originate from primordial germ cells and make up 30% of all ovarian tumors. Mar 01, 2014 an unknown percentage of malignant germ cell tumors reported in phenotypic women may, in fact, represent mtgcts seminomas, embryonal carcinomas, mixed germ cell tumors, as they may have originated from the malignant germ cell component of gonadoblatomas present in dysgenetic gonads of patients with an unrecognized y chromosomecontaining genotype 8, often difficult to demonstrate. When this process begins, there may be no or only vague symptoms. Now i am having some discomfort in my pelvic area and i wonder if it is tumors growing.
Germ cell tumors are composed of a number of histologically different tumor types derived from the primitive germ cells of the embryonic gonad. Ovarian germ cell tumour subtypes were distinct diseases, requiring different management. Dysgerminoma is the most common malignant germ cell tumor of ovary and account for nearly half of all such. Jan 31, 2019 surgical staging is the first step in the management of ovarian germ cell cancer. Ovarian germcell tumors represent 1520% of all ovarian tumors, 3 % of which are malignant. Silly question, but you can only get germ cell tumors cyctic teratoma, dysgerminoma, endodermal sinus tumor and choriocarcinoma from a fertilized egg after having sex right. Gcts that originate outside the gonads may be birth defects resulting from errors during development of. As with epithelial ovarian cancers, it is a good idea to consult with a gynecologic oncologist for. Ovary is most common site of germ cell tumors in females 20 30% of ovarian tumors are germ cell tumors germ cell tumor histogenesis varies depending on neoplastic transformation of germ cells into either mature or embryonal multipotential cells. A germ cell tumour is slightly different than a typical ovarian cancer as it starts in the egg producing part of the ovary.
Germ cell tumours of ovary by dr sreelasya kakarla sri siddhartha medical college and research hospital, tumkur 2. Ovarian germ cell tumors usually occur in teenage girls or young women and most often affect just one ovary the ovaries are a pair of organs in the female reproductive system. Germ cell tumors in the testes of an adolescent male commonly present as an enlarging, solid mass, which may be painful. There have been several published reports of ovarian germ cell cancers affecting more than one family member. Staging system for pediatric ovarian germ cell tumors stage i limited to ovary ovaries. Germ cell ovarian tumors are derived from the egg producing cells within the body of the ovary. In addition, the majority are unilateral, with bilateral ovarian involvement occurring in 10% to 15% of pure dysgerminoma, in some mixed germ cell tumors in which the predominant component is dysgerminoma, and in occasional cases of. Malignant mixed germ cell tumour of ovary an unusual combination. They have been divided into two subtypes according to their cell of origin as follows. These tumors are usually first noticed during the active reproductive years 1,7 and they all have a. The process used to find out whether cancer has spread within the ovary or to other parts of the body is called staging. Germ cell and stromal tumors of the ovary university of kentucky. Within the ovaries, germ cell tumors can usually be distinguished from ovarian cysts, which are much more common, using ultrasound. Ovarian germ cell tumors treatment pdqhealth professional.
Germ cell tumors of the ovary northwestern scholars. A multicentre retrospective cohort study of ovarian germ cell tumours. In one series, the most common component of a mixed germ cell tumor was dysgerminoma, which occurred in 80%, followed by est in 70%, immature teratoma in 53%, choriocarcinoma in 20%, and embryonal carcinoma in 16%. When found in the ovaries and testes, they are often.
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