Malignant ovarian germ-cell tumours

Abstract

Malignant ovarian germ-cell tumours account for about 5% of all ovarian malignancies and typically present in the teenage years. They are almost always unilateral and are exquisitely chemosensitive. As such, the surgical approach in young women with such tumours confined to a single ovary should aim to preserve fertility. In early disease, a unilateral salpingo-oophorectomy with careful surgical staging is of great importance in selecting appropriate adjuvant therapy. In advanced disease, the role of aggressive cytoreducation is not well defined, and removal of both ovaries does not confer improvement in outcome. Bleomycin, etoposide and cisplatin combination chemotherapy is regarded as the gold standard for adjuvant therapy. Studies evaluating ovarian and reproductive capacity after conservative surgery and chemotherapy for malignant ovarian germ-cell tumours have consistently demonstrated excellent prognosis, with the return of normal menstrual function and fertility rates in these women with no increase in the risk of teratogenicity.

Outcomes of Malignant Ovarian Germ-Cell Tumors Treated in Chiang Mai University Hospital over a Nine Year Period

“…However, we found one case age 50 years that presented with stage IIIA, mixed type consisted of EST and immature teratoma. MOGCT in the fifth decade is quite rare (Low et al, 2012). Solheim et al (Solheim et al, 2013) reviewed 351 Norwegian patients with MOGCT and found that patients over 50 years old had a significantly poorer prognosis than younger patients consistent with this case in our study that showed an uneventful outcome even though she received many chemotherapy regimens.…”

“…Although, dysgerminoma represented the most common type of MOGCT in the literature review (Bhurgri et al, 2011., Low et al, 2012, we found dysgerminoa was the third ranking histology in our study while the first ranking was immature teratoma and the second ranking was EST. This finding resembled the Weinberg et al publication (Weinberg et al, 2011).…”

“…As MOGCT often occurs at a young reproductive age and the nature of chemosensitive tumor, the conservative surgical approach including unilateral adnexectomy, omentectomy, peritoneal washing, peritoneal biopsies and retroperitoneal lymphadenectomy followed by adjuvant chemotherapy excepted in dysgerminoma and Grade 1 immature teratomy was recommended with a good outcome in Stage I MOGCT (Low et al, 2012;Matei et al, 2013). However, Mahdi et al, (2011) analyzed 493 MOGCT patients who underwent lymphadenectomy compared to 590 MOGCT patients who did not receive this procedure and found that neither lymphadenectomy nor lymph node metastasis was an independent prognostic factor for survival.…”

Systemic management of malignant ovarian germ cell tumors in older women: two case reports and a review of the literature

“…Dysgerminomas on the other hand constitute a group of slower growing tumors, which can present with nonspecific abdominal symptoms. Less common signs include abdominal distension, fever, ascites and vaginal bleeding [1,3,42,43]. Staging is according to the FIGO system, as for epithelial ovarian cancers.…”

“…Ovarian germ cell tumors (OGCTs) are rare, comprising 2% to 5% of all ovarian malignancies [1]. OGCTs usually occur in young women, with a peak incidence at age 20 years and rare reports when age is over 40 years [2].…”