Dysgerminoma

Template:Infobox medical condition (new) A dysgerminoma is a type of germ cell tumor;<ref name="pmid17587461">Template:Cite journal</ref> it usually is malignant and usually occurs in the ovary.

A tumor of the identical histology but not occurring in the ovary may be described by an alternate name: seminoma in the testis<ref>Template:DorlandsDict</ref> or germinoma in the central nervous system or other parts of the body.

Dysgerminoma accounts for less than 1% of ovarian tumors overall. Dysgerminoma usually occurs in adolescence and early adult life; about 5% occur in pre-pubertal children. Dysgerminoma is extremely rare after age 50. Dysgerminoma occurs in both ovaries in 10% of patients and, in a further 10%, there is microscopic tumor in the other ovary.

Abnormal gonads (due to gonadal dysgenesis and androgen insensitivity syndrome) have a high risk<ref>Nelson Textbook of Pediatrics, 18th ed. Chapter 553. Question 11, Gynecologic Problems of Childhood</ref> of developing a dysgerminoma. Most dysgerminomas are associated with elevated serum lactic dehydrogenase (LDH), which is sometimes used as a tumor marker.

Signs and symptoms

File:Dysgerminoma surgery.jpg

Excision of a dysgerminoma

They are exceptionally associated with hypercalcemia. On gross examination, dysgerminomas present with a smooth, bosselated (knobby) external surface, and are soft, fleshy and either cream-coloured, gray, pink or tan when cut. Microscopic examination typically reveals uniform cells that resemble primordial germ cells. Typically, the stroma contains lymphocytes and about 20% of patients have sarcoid-like granulomas. Metastases are most often present in the lymph nodes.

Diagnosis

LDH tumour markers is elevated in 95% of the cases.

• Dysgerminoma characterized by uniform cells separated by fibrous septa with lymphocytes, H&E stain.
  Dysgerminoma characterized by uniform cells separated by fibrous septa with lymphocytes, H&E stain.
• Low-power view of a dysgerminoma infiltrating the colonic wall, H&E stain.
  Low-power view of a dysgerminoma infiltrating the colonic wall, H&E stain.

Treatment

Dysgerminomas, like other seminomatous germ cell tumors, are very sensitive to both chemotherapy and radiotherapy. For this reason, with treatment patients' chances of long-term survival, even cure, is excellent.<ref name = "Maoz_2020">Template:Cite journal</ref> Targeted treatments for dysgerminomas that do not respond to chemotherapy are being evaluated.<ref name = "Maoz_2020" />