Abnormal gonads due to gonadal dysgenesis and androgen insensitivity syndrome have a high risk of developing a dysgerminoma. Treatment of dysgerminoma may include the following. The fat within the tumor demonstrated characteristic inte. Ovarian dysgerminomas are characteristically solid and well. Ovarian germ cell tumor is a disease in which malignant cancer cells form in the germ egg cells of the ovary. The patient was operated on and the mass was found to have arisen from the left ovary with no macroscopic invasion of surrounding structures. The results of this pilot study show that the most accurate and reproducible mr imagingbased diagnostic criterion for polycystic ovary syndrome in adolescents is an ovarian volume greater than 10. Using a fast 3d sequence with a spatial resolution of 1. Guerriero s1, testa ac, timmerman d, van holsbeke c, ajossa s, fischerova d, franchi d, leone fp, domali e, alcazar jl, parodo g, mascilini f, virgilio b, demidov vn, lipatenkova j, valentin l. The potential of magnetic resonance imaging mri was evaluated in 21 female subjects. Jan 23, 2020 treatment of malignant germ cell tumors of the ovary with bleomycin, etoposide, and cisplatin. Dec 23, 2019 a dysgerminoma is a tumor of the ovary that is composed of primitive, undifferentiated germ cells.
Ultrasound software developed for calculating number, volume of ovarian follicles software called sonographybased automated volume count provides an efficient method of calculating the number and volume of ovarian follicles. Ovarian dysgerminomas are a type of germ cell tumor of the ovary. We encountered a rare case of ovarian dysgerminoma in a 40yearold woman, whose preoperative mri findings consisted predominantly of hemorrhagic multilocules divided by unenhanced irregular septa. Dysgerminomas are malignant germ cell tumors of the ovary that most. Summary mri appearances of a 19yrold woman with solid mature teratoma of the ovary is presented. In addition, a second cancer occurred in 10% of all patients who survived to 10 years and had received radiotherapy compared to 2% of those who had not received radiation treatment p.
Attention to the presence of fatty tissue will contribute to making a correct di agnosis of teratoma, distinguishing it from other germ cell tumors. Age and sex distribution ovarian dysgerminoma is the tumor of young individuals and about 90% of the ovarian dysgerminomas can occur before the age of 30 years. She had no other treatment but her ca125 is and was being monitored. In a 14yearold female with dysgerminoma and coexisting gonadoblastomas. Post contrast imaging can often show enhancement of the septae. Cross sectional imaging plays a crucial role in diagnosis, tumor staging. The lesion was almost entirely solid with small cystic component.
No radiological study has been done to compare the imaging findings between this type of. Twenty patients had a primary ovarian dysgerminoma including the one. Hcg more commonly points to the possibility of an ectopic pregnancy rather than an ovarian malignancy. Figure 1 different techniques for realtime live imaging of the ovary. We examined in situ expression of stem cellrelated nanog, oct34, kit, ap2. Epidemiology they are rare ovarian tumors that occ. Nov 23, 2012 we report that the coincidence of ovarian tumor and pregnancy poses significant challenges that are more pronounced if the pregnancy is ectopic. B positron emission tomographydualmodality computed tomography petct imaging of an ovary for. Arvinder singh 1, surinderpal 2, sohan singh 1, aditi mahajan 1, mohit khandelwal 1 from the department of radiodiagnosis 1 and department of pathology 2, government medical college, amritsar, india. Tumors are often seen divided into lobules by septa. Germ cell tumors arise from primordial germ cells of the ovary and the testis. An ovarian dysgerminoma is a rare, malignant tumor occurring in young women, accounting for 1% to 2% of all primary ovarian neoplasms. A simple left salpingooophrectomy was done followed by radiotherapy and chemotherapy. In a 14yearold female with dysgerminoma and coexisting gonadoblastomas, contrastenhanced magnetic resonance imaging mri demonstrated a solid mass in the right ovary, which presented as hyperintense lobules on diffusionweighted imaging separated by fibrovascular septa.
Mri appearances of ovarian dysgerminoma sciencedirect. Ovarian dysgerminomas are characterised by frequent kit. Therefore, complete lymphadenectomy should be performed. Ovarian torsion is a possible cause of acute abdominal pain in women at any age, especially during their reproductive years 1,2. In a 14yearold female with dysgerminoma and coexisting gonadoblastomas, contrastenhanced magnetic resonance imaging mri. Ovarian dysgerminoma and synchronic contralateral tubal. The ovary contains individual follicles as functional structures, together with corpora lutea, interstitial tissues, innermost medulla and the outmost layer of.
Williams sd, kauderer j, burnett af, lentz ss, aghajanian c, armstrong dk. Jun 15, 2015 ovarian yolk sac tumors ysts are rare neoplasms. No radiological study has been done to compare the imaging findings between this type of tumor and other ovarian tumors. Ovarian germ cell tumor dysgerminoma cleveland clinic. After contrast medium administration, the solid component of the lesions showed. Ovarian germ cell tumours ogcts typically arise in young females and their pathogenesis remains poorly understood. Pelvic mri may be needed if a nonovarian origin for the mass is suspected.
Ct imaging of ovarian yolk sac tumor with emphasis on. Ct findings of 11 cases with pathologically proved dysgerminoma of ovary were retrospectively analyzed. For example, in a series of 129 patients with ovarian dysgerminoma treated between 1983 and 1992, only 29 patients 22% underwent primary surgery in a specialized gynecological oncology center 9. The imaging features of the mass were almost the same as in the first patient. Stage iv ovarian germ cell tumors treatment depends on whether the tumor is a dysgerminoma or another type of ovarian germ cell tumor. A biopsy should be performed on the contralateral ovary at the time of surgery if the ovary is enlarged or appears abnormal. Ovarian dysgerminoma is a common malignant tumor that comprises of ovarian germ cells. Adjuvant therapy of completely resected dysgerminoma with carboplatin and etoposide.
Mri appearances of ovarian dysgerminoma researchgate. One preliminary study demonstrated feasibility of dcemri in ovarian cancer and peritoneal deposits also on a 3 t unit. Individuals with the syndrome are characterized by 46, xy karyotype and phenotypically female with female genital appearance, normal mullerian structures and absent testicular tissue. Dysgerminomas are large average size 15 cm, lobulated, solid, soft fleshy tumors. The condition usually first becomes apparent in adolescence with delayed puberty and primary amenorrhea. Her left ovary was the size of a football the normal size is more like an almond. The cortex of the ovary has numerous primordial germ cells with relatively little stroma. Cns dysgerminoma ovarian dysgerminoma see also germ cell tumors.
Clinical and ultrasound characteristics of ovarian dysgerminoma article in ultrasound in obstetrics and gynecology 375. The mean average age of occurrence of dysgerminoma of ovary is around 22 years. We report the imaging findings of three ovarian dysgerminomas that coexisted with other germ cell tumors or gonadoblastomas, focusing on the distribution of tumor nests and vascular architecture, which might provide information about the pathogenesis of dysgerminomas. The microscopic appearance of ovarian dysgerminoma is identical to that of testicular seminoma and extragonadal germinoma.
Germ cell tumors begin in the reproductive cells egg or sperm of the body. Ultrasound in follicle monitoring for ovulation inductioniui. Transvaginal longitudinal grayscale image of the pelvis showing a. It is diagnosed by physical examination and imaging methods and is treated by salpingooophorectomy, radiation, and chemotherapy. Furthermore, in the limited studies available quantitative analysis was typically performed with inhouse written software 69,70. Ovarian germ cell tumors usually occur in teenage girls or young women and most often affect just one ovary. Ultrasound in follicle monitoring for ovulation inductioniui fig. The ovarian stroma is more abundant in the medulla, where the larger follicles are seen. A bmode ultrasound imaging showing the fuzzy outline of an ovary in an adult c57bl6 mouse. Sep 19, 2011 simple 46, xy gonadal dysgenesis syndrome, also called swyer syndrome, is known as pure gonadal dysgenesis. Ovarian dysgerminoma often forms a multilobulated solid mass divided by fibrovascular septa with few necrotic or hemorrhagic components in the mass. For the purpose of experimentation, the databases d1, d2 and d3, of ultrasound images of ovaries are prepared in consultation with the medical expert, namely, radiologist and gyneocologist, for the present study of the follicle detection and ovarian classification in ovarian images. In section, they appear to consist of different lobules, are soft and. Here, we report a rare and interesting case of a 24yearold nulliparous spanish woman who experienced the coincidental occurrence of left tubal pregnancy and dysgerminoma in the right ovary.
Total abdominal hysterectomy and bilateral salpingooophorectomy followed by chemotherapy, with removal of as much of the cancer in the pelvis and abdomen as possible. On mri, they can sometimes be distinguished from the benign lesions because they originate from the ovary unlike a fibroid, show heterogeneity in tissue. Significant prognostic factors for causespecific mortality in ovarian dysgerminoma included age older than 40 years at diagnosis and metastatic disease. Ct characteristics of ovarian dysgerminoma springerlink. Magnetic resonance mr imaging characteristics of ovarian cystic teratomas were evaluated in 18 patients with 23 surgically proved tumors. Using mainly histological analyses of fixed ovarian tissues and ultrasound imaging of ovaries in vivo, earlier imaging studies have established the basic framework of ovarian folliculogenesis as well as luteal formation and regression. Methodsct findings of 11 cases with pathologically. We investigated the origin of malignant ogcts and underlying molecular events in the development of the various histological subtypes of this neoplasia. Ultrasound imaging, even if using color coded doppler technique may be inconclusive, though an enlarged ovary in association with whirlpool sign is diagnostic 3. Imaging findings of ovarian dysgerminoma with emphasis on. Dysgerminomas are rare ovarian malignancies that primarily affect young.
However, the lesscommon histologic types of primary ovarian malignancies, such as brenner tumor, dysgerminoma, or granulosa cell tumor fig. If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Massive ovarian dysgerminoma presenting as an unusual large intraabdominal mass. Mri, ct, and petct for ovarian cancer detection and adnexal. Ovarian dysgerminoma radiology reference article radiopaedia. Full surgical staging is recommended for ovarian germ cell tumors gcts to identify women with greater than stage ia disease. A diagnosis of ovarian dysgerminoma is rarely suspected before surgery. Simply select your manager software from the list below and click on download. The most commonly occurring gct is the dysgerminoma, which accounts for only 15% of all ovarian cancers.
Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. The pattern of spread for ovarian dysgerminomas often follows a lymphatic rather than peritoneal route, with up to 25% of patients having lymphatic involvement. The most common ovarian germ cell tumors are dysgerminomas, which. They are the most common malignant germ cell tumors of the ovary and are thought to account for 1% of all ovarian neoplasms 5. Hi, i just wanted to say that my stepdaughter was diagnosed at 16 with ovarian dysgerminoma. Dysgerminoma occurs in both ovaries in 10% of patients and, in a further 10%, there is microscopic tumor in the other ovary. The image shows dysgerminoma of the ovary in a 39 yo female. The tumor presented as a solid n 8 or cysticsolid n 3 mass. While imaging tests can reveal a tumor or other mass, they cant determine if its cancerous.
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