However, the majority of ovarian cancers arise from the surface epithelium, a single layer of cells that covers the surface of the ovary. Patnaik department of pathology, the animal medical center, new york, ny abstract. 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. The majority are mature cystic teratomas dermoid cysts in women of reproductive age. Six of the teratomas had immature components and were judged malignant. Pathology outlines who classification of ovarian neoplasms. Management of female malignant ovarian germ cell tumours.
Primitive gcts comprise dysgerminomas and nondysgerminomatous gct, which include yolk sac tumor, embryonal carcinoma, polyembryoma, nongestational choriocarcinoma, and mixed gcts. Germ cell tumors can spread metastasize to other parts of the body. Most germ cell tumors that are cancerous occur as cancer of the testicles testicular cancer or cancer of the ovaries ovarian cancer. The most common sites for metastasis are the lungs.
Germ cells normally occur inside the gonads ovary and testis. Although many reports have been published about germ cell tumors of the ovary in developed countries, there has been no such documentation from nepal. Ovarian germ cell tumor treatment ovarian teratoma treatment. 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. Ovarian germ cell tumors germ cells usually form the ova or eggs in females and the sperm in males. However, the introduction of new stem cell pluripotency. Germ cell tumors begin in the reproductive cells egg or sperm of the body. Less than 2% of ovarian cancers are germ cell tumors. Fourteen ovarian germ cell tumors were diagnosed in the dogseven dysgerminomas and seven teratomas. About 90 percent of ovarian cancers arise in the covering of the ovary. Ovarian germ cell tumors treatment options include surgery, chemotherapy, and radiation therapy. Germcell tumors and sex cordstromal tumors are major types of nonepithelial ovarian malignancies, which account for 1015% of all ovarian tumors 4,5.
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. Most ovarian cancers are a type called epithelial cancer. Some germ cell tumors occur in other areas of the body, such as the abdomen, brain and chest, though it. Germ cell tumors are growths that form from reproductive cells. 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. 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. Ovarian germ cells for the most part, ovarian germ cell tumors have been shown to develop in one ovary among girls between the ages of 10 and 14. Following are common patterns and associated terms. In the event that they are cancerous, these ovarian germ cell tumors are referred to as dysgerminoma. The field of ovarian germ cell tumors ogcts has remained relatively unchanged in the last 2 decades. The mature cystic teratoma, also called dermoid cyst, is by far the most common subtype. Germ cell tumors account for about 2 to 4 percent of all cancers in children and adolescents younger than age 20. Gcts that originate outside the gonads may be birth defects resulting from errors during development of the embryo. Germ cell tumors of the ovary textbook of uncommon.
Ovarian germ cell tumors ogcts are derived from primordial germ cells of the ovary. Ovarian germ cell tumors union for international cancer. Ovarian germ cell tumors gcts are rare tumors affecting predominantly girls or young women. Over the past three decades, survival rates for germ cell tumors have dramatically improved, coincident with more aggressive surgical staging and combination chemotherapy. Germ cell and stromal tumors of the ovary fred ueland, md university of kentucky gynecologic oncology. Ovarian germ cell malignant tumors are uncommon, and account for approximately 5 percent of ovarian cancer cases. Principles of diagnosis and treatment apply across all histological types. Because germ cell tumors can vary greatly, and can arise in different parts of the body, they can be difficult to stage.
They can occur in women of any age, but are more often found in young women or adolescent girls. Germ cell tumors include a number of histologically different tumor types derived from the primitive germ cells of the embryonic gonad. Ovarian dysgerminomas are a type of germ cell tumor of the ovary. Koirala institute of health sciences, dharan, nepal. While sharing many similarities with male germ cell tumours gcts, a group of.
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. They are the most common malignant germ cell tumors of the ovary and are thought to account for 1% of all ovarian neoplasms 5. Ovarian neoplasms coelomic epithelium germ cell specialized gonadal stroma nonspecific mesenchyme metastatic tumors 5070% 1520% 510% 510% 510%. Germ cell tumours tend to affect only one ovary, and most are curable even if diagnosed at an advanced stage. Germ cell tumors germ cell tumors arise from the ovary s germinal elements and comprise a third of all ovarian neoplasms. Ovarian cancer is the most lethal of all of the gynecological cancers and can arise from any cell type of the ovary, including germ cells, granulosa or stromal cells. S u m m a r y germ cell tumors second most common of ovarian tumors. Epidemiology they are rare ovarian tumors that occ. Continued pregnancy after ovarian germ cell tumors. The american joint committee on cancer ajcc tnm classification and the international federation of gynecology and obstetrics figo staging system for germ cell tumors are listed below see tables 1 and 2. More than 95% of gct are benign dermoid cysts mature cystic teratomas.
Germ cell tumors are composed of a number of histologically different tumor types derived from the primitive germ cells of the embryonic gonad. Germ cell tumors of the ovary are presumed to derive from the pathogenic transformation of ovarian germ cells at different stages of development. This accounts for 95 percent of all germ cell tumors and is. 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. Animal models of ovarian cancer reproductive biology and. There are many kinds of germ cell tumors and only some. Malignant ovarian germ cell tumors mogcts are rare but curable at all stages of disease. The retrospective study presented here reports the clinicopathologic profile of germ cell tumors of the ovary studied at b. These tumors frequently affect only one ovary and are generally curable if found and treated early. A germ cell tumour is slightly different than a typical ovarian cancer as it starts in the egg producing part of the ovary. Ovarian germ cell tumors usually occur in teenage girls or young women and most often affect just one ovary.
Ovarian germ cell tumors ogcts are heterogeneous tumors that are derived from the primitive germ cells of the embryonic gonad, which accounts for about 2. Ogcts arise primarily in young women between 10 and 30 years of age and represent 70. 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. A germcell tumor gct is a neoplasm derived from germ cells. The tumor has been entirely removed, and tumor markers are normal. Overall, they have a good outlook, with more than 9 out of 10 patients surviving at least 5 years.
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. Female malignant ovarian germ cell tumours mogcts are rare, but early diagnosis and multiagent chemotherapy are 1associated with high cure rates of 85. Germ cell tumors gct originate from primordial germ cells and make up 30% of all ovarian tumors. 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. Clinical profile and classification germ cell tumors. Malignant gct make up 3% and 20% of all ovarian cancers in western countries and asianafrican countries respectively. Ovarian tumors can also arise from the egg, which leads to germcell tumors gct 6, 31 32 33. Malignant ovarian germ cell tumors mogcts consist of a broad spectrum of tumor types histogenetically derived from primordial germ cells and sexstromal derivatives that differ with regard to clinical presentation, tumor biology, and histology. Malignant germ cell tumors of the ovary follow the same staging system as epithelial ovarian and primary peritoneal cancers. The world health organization histological classification for ovarian tumors separates ovarian neoplasms according to the most probable tissue of origin. Terms germ cells a germ cell is any biological cell that gives rise to the gametes of an organism that reproduces sexually. 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.
In children and adolescents, up to 60% of ovarian tumors can be of germ cell origin. The concept of germ cell tumors as a specific group of gonadal neoplasms has evolved over the last several decades. However, the introduction of new stem cell pluripotency markers has provided a new understanding into the identification and taxonomy of ogct types. They are almost always unilateral and are exquisitely chemosensitive. While sharing many similarities with male germ cell tumours gcts, a group of cancers 20 times more common than mogcts. Germ cells tumors of the ovary account for approximately 1520% of all ovarian tumors. Malignant ovarian germcell tumours account for about 5% of all ovarian malignancies and typically present in the teenage years. As with epithelial ovarian cancers, it is a good idea to consult with a gynecologic oncologist for. Germ cell tumors health encyclopedia university of.
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