Germ Cell Tumors of Ovary
Reviewer(s): Dharam M. Ramnani, MD
Germ cell tumors (GCT) originate from primordial germ cells and make up 30% of all ovarian tumors. More than 95% of GCT are benign dermoid cysts (mature cystic teratomas). Remaining 5% are malignant. Malignant GCT make up 3% and 20% of all ovarian cancers in Western countries and Asian/African countries respectively. Patients with malignant GCT are usually between 15-30 yrs. of age. Tumors are large (average size 16 cm) and generally unilateral (except dysgerminomas; 10-20% cases are bilateral). Presenting symptoms are abdominal enlargement and pelvic pain. Serum hCG and AFP levels can give a clue to the diagnosis and are useful in monitoring postoperatively. The treatment consists of fertility-sparing surgery followed by combination chemotherapy. About 60-75% of patients present with Stage I disease with a cure rate of almost 100%. About 25-30% of cases have Stage III disease at diagnosis and the cure rate is 75%.