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n. disgerminoma, tumor maligno del ovario.
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Pathologic evaluation reported the mass to be a dysgerminoma and gonadoblastoma with the following marker profile: CD117 (+), CEA (-), Desmin (-), GFAP (-), PLAP (+), S-100 (focal+), CK mixed (+), hcG (-) and AFP (-).
The cytologic findings, such as large polygonal cells with centrally placed pleomorphic nuclei and admixed with lymphocytes in the tiger-stripe background, were suggestive of a germ cell tumor (GCT)--that is, dysgerminoma.
Dysgerminoma is said to show a 100% positivity for PLAP, but recent studies counter this.
Lauren, now 16, was diagnosed with stage four ovarian dysgerminoma cancer and was admitted to the Teenage Cancer Trust ward at the University Hospital of Wales.
Figure 2: Distribution of malignant lesions according to histopathological diagnosis HISTOPATHOLOGICAL DIAGNOSIS OF MALIGNANT LESIONS Serous cystadenocarcinoma 3 (17%) Borderline serous tumor 2 (12%) Endometroid ca 1 (6%) Ovarian metastasis 3 (17%) Dysgerminoma 2 (12%) Immature teratoma 1 (6%) Granulosa cell tumor 1 (6%) Brenner tumor 2 (12%) Yolk sac tumor 1 (6%) Sertoli leyding tumor 1 (6%) Note: Table made from pie chart.
Table 1: Morphological classification of ovarian neoplasms Sest Germ cell Sex cord stromal Metastatic Serous Teratoma: Granulosa cell Krukernberg/drop Mature/ immature Mucinous Dysgerminoma Fibrous tumor Loco-regional metastasis Endometrioid Endodermal sinus sclerosing stromal cell (yolk sac) cell Clear cell Choriocarcinoma sertoli-stromal cell (leydig) Brenner Embryonal cell Steroid cell Undifferentiated Struma ovarii
0%) had malignant masses (specifically, one Krukenberg tumor, one dysgerminoma, one malignant mixed tumor, one immature teratoma, one mucinous adenocarcinoma, and two primitive neuroectodermal tumors (PNETs)), and one woman (5.
Treatment for early-stage dysgerminoma is surgical; young women should have at least unilateral oophorectomy performed; if the contralateral ovary is spared there's a 10% risk for recurrence over the next 2 years.
We present an extremely rare case of an adrenal mixed GCT composed of dysgerminoma and embryonal carcinoma.
Literature reports the most common components of such tumors as dysgerminoma (80%), EST (Endodermal Sinus Tumor) (70%), immature teratoma (%53), choriocarcinoma (20%), and embryonal carcinoma (16%).
The 2nd major category was of germ Cell origin of which dysgerminoma was the commonest subtype.
Thus, together with findings in studies from the United States of America and India, dysgerminoma is confirmed as the commonest malignant germ cell tumour (9).