The most common pure germ cell tumour of the ovary
Correct Answer: Dysgerminoma
Description: Ans. is b i.e. Dysgerminoma "Dysgerminoma is the most common malignant germ cell tumour accounting for about 40% of all ovarian cancers of germ cell origin." "Dysgerminomas are the most common malignant germ cell tumours of the ovary and have been considered the female - equivalent of seminoma." Most common germ cell tumour of ovary is dermoid cyst (mature teratoma). It is benign in nature. Dysgerminoma Commonest malignant germ cell tumourdeg of ovary. Primarily affect young women (average age of incidence is 20 yearsdeg). Usually unilateraldeg but they are the only germ cell malignancy with a significant rate of bilateral ovarian involvement - 15 to 20%. Can be found at gonadal as well as extra gonadal sites.deg Pathologically it is a solid neoplasm with areas of softeningdeg due to degeneration. They are the most common ovarian malignancy detected during pregnancy. Histologically as in seminoma, it mimics the pattern of primitive gonad, lymphocytic infiltration may be seen (good prognostic sign).deg Clinically as with all germ cell tumours most dysgerminoma are diagnosed at an early stage. Unlike other germ cell tumours it does not secrete AFP and HCG is only rarely secreted, however it secretes LDH and placental alkaline phosphate, which are used as tumour marker of dysgerminoma. Although dysgerminoma is most radio sensitive tumouty2treatment of choice is surgery (unilateral salpingo oophorectomy) followed by Bleomycin, Etoposide and Cisplatin (BEP) based chemotherapy as feility can be preserved. They have the best prognosis of all malignant ovarian germ cell variants. Tumours associated with it : - Immature teratoma - Choriocarcinoma - Endodermal sinus tumour. Dysgerminomas are also seen in phenotypic females with abnormal gonads like : Pure gonadal dysgenesis (46XY with bilateral streak gonads, swyer syndrome) Mixed gonadal dysgenesis Testicular feminization syndrome (46XY) Klinfelter syndrome For patients in whom karyotype reveals Y chromosome, both ovaries should be removed although uterus may be left in situ for possible future embryo transfer.
Category:
Gynaecology & Obstetrics
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