Types of germ cell tumors teratoma dysgerminoma endodermal sinus tumor yolk sac tumor. Jul 14, 2016 ovarian germ cell tumor is a disease in which malignant cancer cells form in the germ egg cells of the ovary. Stages of ovarian germ cell tumors navigating care. Recurrent ovarian mixed germ cell tumor with unusual. For more information on a germ cell tumor in the reproductive organs, read about ovarian and testicular cancer. They are almost always unilateral and are exquisitely chemosensitive. They are the most common malignant germ cell tumors of the ovary and are thought to account for 1% of all ovarian neoplasms 5. A germ cell tumour is slightly different than a typical ovarian cancer as it starts in the egg producing part of the ovary. Primary mediastinal germ cell tumor the mediastinum is the most common site of extragonadal germ cell tumors 11, constituting 5070% of all extragonadal germ cell tumors. Malignant germ cell tumors account for less than 5% of all ovarian neoplasms. Ovarian germ cell tumors treatment pdqpatient version.
It is intended as a resource to inform and assist clinicians who care for cancer patients. Germ cell tumours are a heterogeneous group of neoplasms that present across a wide age range and vary in site, histology, and clinical behaviour. In the simplest of terms, germ cells are the cells that form eggs, dr. The management of malignant ovarian germ cell tumors is predicated on the histologic identity of the tumor see fig. All other histologic types require adjuvant chemotherapy, and therefore. Thus, staging, risk stratification, and treatment approaches for germ cell. Ovarian dysgerminomas are a type of germ cell tumor of the ovary. Ovarian germ cell tumors usually occur in teenage girls or young women and most often affect just one ovary. The most common sites for metastasis are the lungs. Pdf fertility preservation in the management of germ. These lesions mostly occur in the first two decades of life, whereas immature teratomas are the second most frequent type 20% 35. The sooner ovarian cancer is found and treated, the better your chance for recovery. Germ cell tumors can spread metastasize to other parts of the body.
Ovarian cancer is a broad term used for a wide range of neoplasms that originate in the ovary. Stages of ovarian germ cell tumors after ovarian germ cell tumor has been diagnosed, tests are done to find out if cancer cells have spread within the ovary or to other parts of the body. Ovarian germ cell tumors ogcts are derived from primordial germ cells of the ovary. Ovarian germ cell tumor treatment ovarian teratoma treatment. Bc cancer protocol summary for therapy of ovarian germ cell. Other types of ovarian cancer include ovarian low malignant potential tumor olmpt, germ cell tumors, and sex cordstromal tumors like the granulosastromal tumors and sertolileydig cell tumors. Cases of malignant ovarian tumors consisting of clear cell carcinoma ccc and yolk sac tumor yst are decidedly rare. Unlike their carcinoma counterparts, ovarian sarcoma tumors develop in the. Most ovarian germ cell tumors are benign, but some are cancerous and may be life threatening. Malignant ovarian germ cell tumors spread in the same manner as epithelial ovarian neoplasms but are more likely to involve regional lymph nodes. As part of one of the worlds most active cancer centers, childrens cancer hospital has remarkable experience and skill in these types of cancer. Type 4 germ cell tumours are equivalent to ovarian dermoid cysts. The ovaries each about the size of an almond produce eggs ova as well as the hormones estrogen, progesterone and testosterone.
Compared with epithelial ovarian cancers, nonepithelial ovarian tumors are uncommon. Nonepithelial ovarian cancer esmo clinical practice. The latter comprise granulosa cell tumors, fibroma, thecoma and fibrothecoma. Germ cell tumors atlas of genetics and cytogenetics. Inherited mutations in the brca1 and brca2 genes greatly increase a womans ovarian cancer risk as well as breast cancer risk. With the advent of combination chemotherapy, risk of relapse has markedly decreased. Patients with germ cell tumours are managed by a diverse array of specialists. Germ cell tumors account for about 2 to 4 percent of all cancers in children and adolescents younger than age 20. The field of ovarian germ cell tumors ogcts has remained relatively unchanged in the last 2 decades. Paediatric extracranial germcell tumours the lancet. Female malignant ovarian germ cell tumours mogcts are rare, but early diagnosis and multiagent chemotherapy are 1associated with high cure rates of 85. In contrast to epithelial ovarian cancer eoc, they constitute a rare form of ovarian. An ovarian germ cell tumor is a growth in a womans ovaries. It explores possible symptoms, treatment options, and factors that affect a womans prognosis.
Ovarian germ cell tumors treatment pdq pubmed health. For the management of abnormal cervical screening tests and cancer precursors. Each group contains several histologic ovarian tumor subtypes table 10. Germ cell ovarian cancer md anderson cancer center. Jun 24, 2019 germ cell ovarian cancer cases make up less than 2% of all ovarian cancer diagnoses, according to the acs. Mature teratomas are the most common type of benign germ cell tumor. Ovarian cancer is a type of cancer that begins in the ovaries.
Ovarian germ cell tumors germ cells usually form the ova or eggs in females and the sperm in males. This disruption can result from uncontrolled cell growth or loss of a cells ability to undergo apoptosis. Pdf malignant ovarian germcell tumours researchgate. Malignant ovarian germ cell tumours account for about 5% of all ovarian malignancies and typically present in the teenage years. The process used to find out whether cancer has spread within the ovary or to other parts of the body is called staging. Pediatric and adolescent extracranial germ cell tumors. Malignant germ cell tumors of the ovary follow the same staging system as epithelial ovarian and primary peritoneal cancers. It makes some excellent points about the widespread nature of tumours with germ cell differentiation. A multicentre retrospective cohort study of ovarian germ cell tumours. Malignant germ cell tumors lcoh10 surveillance for malignant germ cell and sex cordstromal tumors lcoh12. Women with ovarian cancer may have no symptoms or just mild symptoms until the disease is in an advanced stage. Treatment of children and adolescents with stage ii testicular and stages i and ii ovarian malignant germ cell tumors. Like their male germ cell counterparts chapter 206, these malignances are extremely chemosensitive and have a high cure rate, even if discovered at an advanced stage. 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.
May 25, 2019 germ cell tumors are growths that form from reproductive cells. Signs of ovarian germ cell tumor are swelling of the abdomen or vaginal bleeding after menopause. Several new treatment algorithms are featured as well as an extensive summary of. They are rare and usually affect girls and young women up to their early 30s. Bc cancer protocol summary for therapy of ovarian germ. In women, this type begins in the cells that form eggs in the ovaries, known as germ cells. Germ cell tumors less than 2% of ovarian cancers are germ cell tumors. Ovarian germ cell tumor dysgerminoma cleveland clinic. Germ cell tumors outside of the brain can be divided into gonadal and extragonadal. Germ cell tumors are a histologically heterogeneous group of tumors that share a common origin. Yolk sac tumors, also called endodermal sinus tumors are usually cancer. Germ cell and nonepithelial ovarian cancer oncohema key. These updated guidelines on nonepithelial ovarian cancer cover prevention, diagnosis, treatment and followup for early and advanced stages and recurrences of germ cell tumours, sex cordstromal tumours and small cell carcinomas of the ovary hypercalcaemic type.
Nccn clinical practice guidelines in oncology nccn. For pure form tumors or a component of mixed germ cell tumors, the prognosis of immature teratomas is greatly dependent on the initial stage and. Germ cell tumors health encyclopedia university of. Ovarian cancer is rare, accounting for about 3 percent of cancers among women. Our renowned experts customize your childs care for childhood germ cell tumors, utilizing the most advanced treatments and techniques with the least impact on your childs growing body.
Germ cell ovarian cancer is a type of ovarian cancer that originates from the germ cells of the ovary. Cancer of the ovary is not common, but it causes more deaths than other female reproductive cancers. There have been several published reports of ovarian germ cell cancers affecting more than one family member. The bilateral ovarian involvement represents a critical issue when diagnosed in. They constitute about 20%25% of all ovarian neoplasms. Tests that examine the ovaries, pelvic area, blood, and ovarian tissue are used to detect find and diagnose ovarian germ cell tumor. Table 1 subtypes and characteristics of ovarian germ cell tumours data derived from rice, 1999 and john hopkins pathology, 2001. Malignant ovarian germ cell tumors ogcts historically carried a poor prognosis, especially among those diagnosed with advanced disease. Ovarian germ cell cancers are uncommon malignancies observed in adolescent girls and young women.
Gonadal germ cell tumors start and stay in a childs reproductive organs, which are the testicles or ovaries. 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 cell tumors. Germ cell and stromal tumors of the ovary fred ueland, md university of kentucky. Ovarian neoplasms coelomic epithelium germ cell specialized gonadal stroma nonspecific mesenchyme metastatic tumors 5070% 1520% 510% 510% 510%. Only about 1 or 2% of ovarian cancers are this type. Germ cells that are stranded or have gone astray during their migration between the yolk sac and the developing gonads may develop into germ cell tumors outside the gonads. Most germ cell tumors that are cancerous occur as cancer of the testicles testicular cancer or cancer of the ovaries ovarian cancer. While the most common types of ovarian cancer are epithelial, germ cell and stromal tumors, some of the rarer types of ovarian cancer occur more than others. Berek and others published germ cell and nonepithelial ovarian cancer find, read and cite all the research you need on researchgate. Germ cell tumors also exhibit a unique biology and genetics that distinguish them from other solid tumors and might contribute to their. Female malignant ovarian germ cell tumours mogcts are rare, but early diagnosis and multiagent chemotherapy are associated with high cure rates. Tests that examine the ovaries, pelvic area, blood, and ovarian tissue are used to detect find and diagnose ovarian germ. Treatment of malignant germ cell tumors of the ovary.
They are typically diagnosed when an adnexal mass is found on examination in 12% of all pregnancies, a tumor is seen on ultrasound, or the parents level of alphafetoprotein is elevated. Management of female malignant ovarian germ cell tumours. Ovarian malignant germ cell tumors rsna publications online. You might have chemotherapy if your tumour is cancerous. In children and adolescents, up to 60% of ovarian tumors can be of germ cell origin. Some germ cell tumors occur in other areas of the body, such as the abdomen, brain and chest, though it.
Ovarian germcell tumors represent 1520% of all ovarian tumors. Bc cancer protocol summary for therapy of ovarian germ cell cancer using bleomycin, etoposide, and cisplatin protocol code gobep tumour group gynecology contact physician dr. Ovarian germ cell cancer dysgerminoma yolk sac tumour immature teratoma mixed germ cell tumour bep. A pediatric intergroup studypediatric oncology group 9048 and childrens cancer group 8891. Management of paediatric extracranial germ cell tumours carries a unique set of challenges. Based on the putative cell of origin, ovarian neoplasms are classi. Germ cells tumors of the ovary account for approximately 1520% of all ovarian tumors. Germ cell and nonepithelial ovarian cancer request pdf. They include malignancies of germ cell origin, sexcordstromal cell origin, metastatic carcinomas to the ovary, and a variety of extremely rare ovarian cancers, for example, sarcomas and lipoid cell tumors. Ovarian cancer ovarian cancer symptoms medlineplus. Since that time, newer drugs including cisplatin have increased the cure rate of these tumors to over 80%, even in patients with metastatic disease. Pdf germ cell tumors of the ovary an update researchgate.
It was recognized in the 1960s that testicular germ cell tumors were curable with chemotherapeutic drugs. Germ cell tumors begin in the reproductive cells egg or sperm of the body. Endometrioid and clear cell cancer are associated with endometriosis of the ovary or in the pelvis in 1550% of cases. Ovarian germ cell tumors treatment pdqhealth professional. Ovarian cancer actually refers to several different types of cancer more than 30, in fact. We herein report the case of a 58yearold woman with an ovarian tumor, of which approximately 70 percent was.
Nonepithelial malignancies of the ovary account for approximately 10% of all ovarian cancers 1,2. As with epithelial ovarian cancers, it is a good idea to consult with a gynecologic oncologist for treating malignant germ cell tumors, especially because these are so uncommon. 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. Apoptosis, or cell suicide, is the mechanism by which old or damaged cells normally selfdestruct.
Ovarian germ cell tumor is a disease in which malignant cancer cells form in the germ egg cells of the ovary. You will read about how to cope with challenges in everyday life after your childs diagnosis. There are four main types of ogcts, namely dysgerminomas, yolk sac tumor, teratoma, and choriocarcinoma. Fertility preservation in the management of germ cell ovarian cancer article pdf available in cme journal of gynecologic oncology 82 july 2003 with 275 reads how we measure reads. This emedtv resource offers a detailed discussion of ovarian germ cell cancer, a disease in which malignant cells form in the germ cells of the ovary. Stromal tumours about 1% of ovarian cancers are ovarian stromal cell tumors. The ovarian germ cells are the origin of a number of tumors that are identical to testicular germ cell tumors. Ogcts arise primarily in young women between 10 and 30 years of age and represent 70.
Germ cell and stromal tumors of the ovary university of kentucky. Dysgerminoma is the most common germ cell tumor, accounting for 50% of all germ cell tumor cases. 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. In adults, the vast majority of germ cell tumors are benign nearly all mature cystic teratomas. Jul 25, 2019 ovarian cancer is a type of cancer that begins in the ovaries. Malignant germ cell tumors are the type of ovarian cancer most likely to occur during pregnancy. While sharing many similarities with male germ cell tumours gcts, a group of cancers 20 times more common than mogcts, women who relapse with this cancer have poorer outcomes. Nonepithelial ovarian neoplasms are rare and include germ cell tumors and sex chordstromal tumors. Most ovarian cancers are a type called epithelial cancer. Non cancerous benign teratomas are the most common type.
Bilaterality is rare in malignant ovarian germ cell tumors mogts. Most ovarian germ cell tumours occur in teenagers or young women, although they also occur in women in their 60s. Epidemiology they are rare ovarian tumors that occ. About 23% of all ovarian cancers are germ cell tumors. While sharing many similarities with male germ cell tumours gcts, a group of cancers 20 times more common than mogcts. 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. In children and adolescents, 60% of ovarian neoplasms are of germ cell origin, of which are malignant. Germ cell ovarian tumours begin in the ovarian cells that develop into eggs germ cells. Management of bilateral malignant ovarian germ cell tumors. Nonseminomatous germ cell tumors are cancer and are found in the brain. Germ cell ovarian cancer cases make up less than 2% of all ovarian cancer diagnoses, according to the acs. The types of ovarian cancer are grouped by the kind of cell where they start your ovaries have three.
Ovarian germ cell tumors ogcts are rare tumors that comprise a diverse group of histologic subtypes that can either be benign or malignant. Germ cell tumours tend to affect only one ovary, and most are curable even if diagnosed at an advanced stage. Patients with clinical stage ia dysgerminoma and those with clinical stage iaib grade i immature teratoma require surgical staging to determine the need for adjuvant chemotherapy fig. It also makes the point that not all germ cell tumours are necessarily derived from germ cells in the presence of type 6. The female reproductive system contains two ovaries, one on each side of the uterus.