Dysgerminoma

Ovarian dysgerminoma is a histological type of ovarian germ cell tumor and accounts for 1–3.75% of all malignant ovarian tumors and about 50% of all malignant germ cell tumours (1):

• initial diagnosis is made when the patients are in the first to third decade of life
  • a study concerning germ cell tumours found that the mean age of diagnosis was 22 years (with dysgerminoma accounting for 45% of germ cell tumours in this study (2))
  • dysgerminomas make up two thirds of all malignant ovarian neoplasms in women younger than 20 years
• serum LDH and and alkaline phosphatase (ALP) are often nonspecifically elevated

The dysgerminoma is homologous to the testicular seminoma. Placental alkaline phosphatase - PLAP - is the most useful tumour marker; hCG and AFP are of no value.

Dysgerminomas are highly radiosensitive. When fertility is not an issue, hysterectomy and bilateral salpingo - oophorectomy, with post-operative radiotherapy is the treatment of choice.

Unilateral oophorectomy may be performed in a young woman wishing to preserve fertility, backed up by chemotherapy if there is disseminated disease. Combinations of drugs commonly used include vincristine, actinomycin-D, and cyclophosphamide (VAC), and vinblastine, bleomycin, and cis-platinum (VBP).

5 year survival rates are 95% for stage I disease, 80% for stage II, and 60-70% for stage III.

Reference:

1. Kitajima K et al. MRI appearances of ovarian dysgerminoma. Eur. Journ. Radiol. Extra 2007; 61: 23-25.
2. Zanagnolo V et al. Clinical review of 55 cases of malignant ovarian germ cell tumors. Eur J Gynaecol Oncol. 2004;25(3):315-20
3. Skof E et al. Survival and fertility of patients with malignant ovarian germ cell tumours. Eur J Gynaecol Oncol. 2004;25(6):702-6.