In children and adolescents, up to 60% of ovarian tumors can be of germ cell origin. Continued pregnancy after ovarian germ cell tumors. While sharing many similarities with male germ cell tumours gcts, a group of. Germ cell ovarian cancer is a type of ovarian cancer that originates from the germ cells of the ovary. With the advent of combination chemotherapy, risk of relapse has markedly decreased.
Germ cell tumors germ cell tumors arise from the ovarys germinal elements and comprise a third of all ovarian neoplasms. The mature cystic teratoma, also called dermoid cyst, is by far the most common subtype. As with epithelial ovarian cancers, it is a good idea to consult with a gynecologic oncologist for. Primary malignant tumors of ovary, fallopian tube or peritoneum includes all primary epithelial borderline tumors and carcinomas, carcinosarcoma, malignant germ cell tumors, and malignant sex cordstromal tumors. Patnaik department of pathology, the animal medical center, new york, ny abstract. Paediatric extracranial germcell tumours the lancet. Anderson hospital and tumor institute at houston, were treated with a. Surgical staging is the first step in the management of ovarian germ cell cancer. Six of the teratomas had immature components and were judged malignant. Age, histologic type, tumor size, stage, treatment mode, type of surgery of 67 patients with malignant germ cell tumors managed consecutively were evaluated retrospectively using multivariate analysis. Germ cells normally occur inside the gonads ovary and testis. A modified version of the third who classification 2003 version of germ cell tumors of the ovary is presented in table 2.
Terms germ cells a germ cell is any biological cell that gives rise to the gametes of an organism that reproduces sexually. Ovarian germ cell tumor is a disease in which malignant cancer cells form in the germ egg cells of the ovary. The world health organization histological classification for ovarian tumors separates ovarian neoplasms according to the most probable tissue of origin. Although many reports have been published about germ cell tumors of the ovary in developed countries, there has been no such documentation from nepal. The stats germ cell tumors second most common group of ovarian tumors all ages from infancy to old age seen most frequently from the. Eightyone patients with ovarian germ cell malignancies immature teratoma 29, dysgerminoma 26, endodermal sinus tumors 15, mixed germ cell tumor 8, other 3 seen or consulted on at yale. Germcell tumours are a heterogeneous group of neoplasms that present across a wide age range and vary in site, histology, and clinical behaviour. Ovarian germ cell tumours gcts account for approximately five percent of all ovarian cancers and are most commonly diagnosed in young women.
Germ cell tumors presumed to derived from the pathogenic transformation of ovarian germ cells being unique in the fact that they recreate, however imperfectly, aspects of human development. 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. Ovarian germ cell tumors treatment pdqpatient version. The ovaries are mainly made up of 3 kinds of cells. The retrospective study presented here reports the clinicopathologic profile of germ cell tumors of the ovary studied at b. Germ cell tumors begin in the reproductive cells egg or sperm of the body. Germ cell tumors are growths that form from reproductive cells. This protocol is not required for accreditation purposes for the following. There have been several published reports of ovarian germ cell cancers affecting more than one family member. Management of paediatric extracranial germcell tumours carries a unique set of challenges. 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. Germ cell and stromal tumors of the ovary fred ueland, md university of kentucky gynecologic oncology. Germ cell ovarian tumors causes, symptoms, diagnosis. The latter have, however, a different histogenesis, originating in the testis from malignant germ cells,3 as opposed to ovarian germ cell neoplasms, which are mostly parthenogenetically conditioned.
Staging includes peritoneal cytology, hysterectomy, bilateral salpingooophorectomy, omentectomy, and exploration of peritoneal surfaces and diaphragm with biopsies. Ovarian germ cell tumors gcts are rare tumors affecting predominantly girls or young women. Get detailed treatment information for newly diagnosed or recurrent germ. Ovarian germ cell tumors treatment options include surgery, chemotherapy, and radiation therapy.
Most germ cell tumors that are cancerous occur as cancer of the testicles testicular cancer or cancer of the ovaries ovarian cancer. Germ cell tumors are composed of a number of histologically different tumor types derived from the primitive germ cells of the embryonic gonad. Ogcts arise primarily in young women between 10 and 30 years of age and represent 70. If disease appears to be limited to the ovaries or pelvis, a pelvic and paraaortic lymphadenectomy should also be performed.
Pathology outlines who classification of ovarian neoplasms. Patients with germcell tumours are managed by a diverse array of specialists. 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. Clinical profile and classification germ cell tumors. Primitive gcts comprise dysgerminomas and nondysgerminomatous gct, which include yolk sac tumor, embryonal carcinoma, polyembryoma, nongestational choriocarcinoma, and mixed gcts. These tumors affect both adults and children and therefore the recommendations apply to the eml lists for both adults and children regimen distinctions are included in the present briefing. 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. Ovarian germ cell tumors usually occur in teenage girls or young women and most often affect just one ovary. Germ cells tumors of the ovary account for approximately 1520% of all ovarian tumors. The results of this study demonstrate that most malignant germ cell tumors of the ovary in korean women are detected in the early stage and have excellent survival outcomes with conservative. They can occur in women of any age, but are more often found in young women or adolescent girls. However, these tumours are rare, occurring annually in.
Seven tumor markers in benign and malignant germ cell. Malignant ovarian germ cell tumors ogcts historically carried a poor prognosis, especially among those diagnosed with advanced disease. Principles of diagnosis and treatment apply across all histological types. Malignant germ cell tumors gct of the ovary account for 23% of all ovarian neoplasms and occur mostly in the second and third decade of life. These tumors frequently affect only one ovary and are generally curable if found and treated early. There are many kinds of germ cell tumors and only some. Within the ovaries, germ cell tumors can usually be distinguished from ovarian cysts, which are much more common, using ultrasound. Germ cell tumors of the ovary textbook of uncommon. Positive rate of afp was 100% in yolk sac tumor, 61.
The concept of germ cell tumors as a specific group of gonadal neoplasms has evolved over the last several decades. While sharing many similarities with male germ cell tumours gcts, a group of cancers 20 times more common than mogcts. 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. To determine the most important prognostic factors in patients with malignant germ cell tumors of the ovary. Protocol for the examination of specimens from patients.
Germ cell tumors start from the cells that produce the eggs ova. Ovarian germ cell tumors union for international cancer. Ovarian germ cell tumors ogcts are rare tumors that comprise a diverse group of histologic subtypes that can either be benign or malignant. Fourteen ovarian germ cell tumors were diagnosed in the dogseven dysgerminomas and seven teratomas. Cellular classification and clinical and imaging features1 ovarian malignant germ cell tumors omgcts are heterogeneous tumors that are derived from the primitive germ cells of the embryonic gonad. A germcell tumor gct is a neoplasm derived from germ cells. But germ cells can sometimes be left behind in other parts of the body from when you developed in the womb.
Epithelial tumors start from the cells that cover the outer surface of the ovary. However, the introduction of new stem cell pluripotency markers has provided a new understanding into the. Gcts that originate outside the gonads may be birth defects resulting from errors during development of the embryo. Female malignant ovarian germ cell tumours mogcts are rare, but early diagnosis and multiagent chemotherapy are 1associated with high cure rates of 85. Seven tumor markers were analyzed clinically in 5 patients with germ cell tumors of the ovary who were treated in tokai ovarian tumor study group, an association comrising nagoya university and its affiliated hospitals, between january 1979 and september 1990. Ovarian neoplasms coelomic epithelium germ cell specialized gonadal stroma nonspecific mesenchyme metastatic tumors 5070% 1520% 510% 510% 510%. Germ cell tumours most often develop in the ovary or testicle because this is where most germ cells are.
The most common sites for metastasis are the lungs. 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. Thirty patients with tumors of the ovarian stroma 28 granulosa cell tumors, two androblastomas and 12 women with germcell tumors nine dysgerminomas, two teratomas, one endodermal sinus tumor were treated at the department of obstetrics and gynecology of the university in graz between 1972 and 1989. Germ cell tumors of the ovary an update francisco f. This accounts for 95 percent of all germ cell tumors and is. Koirala institute of health sciences, dharan, nepal. Germ cell tumors starting within the brain are discussed further under brain tumors.
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. Germ cell tumors account for about 2 to 4 percent of all cancers in children and adolescents younger than age 20. Fiftysix women 78% presented with stage i disease, and 16 22% had more. Each type of cell can develop into a different type of tumor. Fifteen patients with malignant nondysgerminomatous germ cell tumors of the ovary seen at the university of texas m.
Ovarian germ cell malignant tumors are uncommon, and account for approximately 5 percent of ovarian cancer cases. These are the cells in the body that develop into sperm and eggs. Experience with stromal tumors and germcell tumors of the. Germ cell tumors of the ovary are presumed to derive from the pathogenic transformation of ovarian germ cells at different stages of development. Whether you can get pregnant after a germ cell tumor depends on the type of surgery you have if only one ovary and fallopian tube are removed. Over the past three decades, survival rates for germ cell tumors have dramatically improved, coincident with more aggressive surgical staging and combination chemotherapy. In fact, eighty percent of preadolescent malignant ovarian tumors are gcts. Ovarian germ cell tumors ogcts are derived from primordial germ cells of the ovary. Thus, staging, risk stratification, and treatment approaches for germcell. Germ cell tumors can spread metastasize to other parts of the body. Germ cell tumors in the testes of an adolescent male commonly present as an enlarging, solid mass, which may be painful.
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