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GERM CELL TUMORS

  • Account for about 5% of all ovarian tumors
  • There are two types:
    • Dysgerminoma: consists of mature and immature teratomas (15% bilateral)
    • Non-dysgerminomas: subdivision includes:
      1. embryonal carcinomas
      2. choriocarcinomas
      3. 3. Mixed cell tumors
      4. Endodermal sinus tumors
  • Most germ cell tumors are unilateral

    SIGNS AND SYMPTOMS
  • Similarly presentation as in ovarian cancers
    Younger patients are affected
  • Diagnosis requires measurement of tumor markers
    • b-Human chronic gonadotropin
    • Alpha fetoprotein

    Dysgerminomas usually have elevated alpha-fetoprotein while non-dysgerminomes have both elevated immature teratomas may have increased b-HCG.

    MANAGEMENT
  • In early disease dysgerminomas, removal of the fallopian tube and ovary (unilateral Salpingo-oophorectomy) on the affected side is mandatory and a biopsy of the other ovary must be done.
  • These tumors are treated with chemotherapeutic agents in advanced cases
  • The tumors are chemo-sensitive
  • In advanced, metastatic disease (dysgerminomas and non-dysgerminomas, chemotherapy, which consists of Bleomycin, VP-16 & Cisplatin may be used
  • If there is recurrence, salvage therapy should be considered (see ovarian cancers)