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The American Journal of Surgical... Oct 2004The prognosis and therapy for dysgerminomas are different from those of other ovarian tumor types, making accurate diagnosis imperative for patient care. OCT4 (POU5F1)...
The prognosis and therapy for dysgerminomas are different from those of other ovarian tumor types, making accurate diagnosis imperative for patient care. OCT4 (POU5F1) is a transcription factor involved in the regulation of pluripotency during embryonic development. It can be detected in both pluripotent cells and other early germ cells. This study examines the expression of OCT4 in both dysgerminoma and nondysgerminomatous neoplasms involving the ovary. Formalin-fixed, paraffin-embedded cell blocks of 33 cases of dysgerminoma including 2 cases of gonadoblastoma associated with dysgerminoma and 3 cases of metastatic dysgerminoma, and 111 cases of nondysgerminomatous neoplasms involving the ovary were stained using the antibody against OCT4. All cases of dysgerminomas and gonadoblastomas were positive for OCT4 with strong nuclear staining. More than 90% of dysgerminoma cells in each case showed diffuse strong nuclear staining. In addition, 3 metastatic dysgerminomas also showed uniform strong nuclear staining. All nondysgerminomatous tumors (mature teratoma, 14; yolk sac tumor, 4; Sertoli-Leydig cell tumor, 15; granulosa cell tumor, 22; Brenner tumor, 3; carcinoid tumor, 4; struma ovarii, 2; fibroma, 5; thecoma, 1; serous adenocarcinoma, 5; endometrioid adenocarcinoma, 4; small cell carcinoma, 6; stromal sarcoma, 1; malignant lymphoma, 6; metastatic malignant melanoma, 1; metastatic carcinoid, 2; metastatic small cell carcinoma, 1; and metastatic lobular carcinoma of the breast, 1) were negative for OCT4, except for some cases of clear cell adenocarcinoma of the ovary. Four of 14 clear cell adenocarcinomas showed focal positive nuclear immunoreactivity for OCT4. OCT4 is a sensitive and relatively specific biomarker for the detection of dysgerminoma. It may also be useful in the diagnosis of gonadoblastoma, which contains similar cells and may be associated with dysgerminoma. OCT4 may aid in the detection of small foci of metastatic dygerminoma in extraovarian sites and may also help distinguish dysgerminoma from other primary and metastatic tumors of the ovary.
Topics: Adenocarcinoma, Clear Cell; Adolescent; Adult; Biomarkers, Tumor; Cell Nucleus; Child; DNA-Binding Proteins; Diagnosis, Differential; Dysgerminoma; Female; Gonadoblastoma; Humans; Immunohistochemistry; Middle Aged; Necrosis; Octamer Transcription Factor-3; Ovarian Neoplasms; Sensitivity and Specificity; Staining and Labeling; Transcription Factors
PubMed: 15371950
DOI: 10.1097/01.pas.0000135528.03942.1f -
World Journal of Surgical Oncology Jun 2007Dysgerminoma is the most common malignant germ cell tumor of the ovary. This malignancy can be associated with pure gonadal dysgenesis or Swyer syndrome, mixed gonadal...
BACKGROUND
Dysgerminoma is the most common malignant germ cell tumor of the ovary. This malignancy can be associated with pure gonadal dysgenesis or Swyer syndrome, mixed gonadal dysgenesis and partial gonadal dysgenesis.
CASE PRESENTATION
Dysgerminoma developed in 3 phenotypic female patients with 46 XY pure gonadal dysgenesis. All patients presented first with abdominopelvic mass. Laparatomy was done. 46 XY karyotype was made by lymphocyte culture. Then these patients underwent gonadectomy that histopathology results were streak ovaries without evidence for malignancy. Two patients received postoperative adjuvant therapy.
CONCLUSION
In Patients with Swyer syndrome the risk of dysgerminoma is high and gonadectomy is recommended. Also 5% of dysgerminomas are discovered in phenotypic female and 46 XY karyotype, thus in adolescent with dysgerminoimas and amenorrhea, karyotype should be done.
Topics: Adolescent; Biopsy, Needle; Chemotherapy, Adjuvant; Dysgerminoma; Female; Gonadal Dysgenesis, 46,XY; Humans; Immunohistochemistry; Laparotomy; Neoplasm Staging; Ovarian Neoplasms; Ovariectomy; Prognosis; Risk Assessment; Sampling Studies; Treatment Outcome; Ultrasonography, Doppler; Young Adult
PubMed: 17587461
DOI: 10.1186/1477-7819-5-71 -
Medical Oncology (Northwood, London,... Dec 2012Ovarian dysgerminomas are rare entity and account for only about 2% of all malignant ovarian neoplasm. The aim of this study was to evaluate the clinicopathologic...
Ovarian dysgerminomas are rare entity and account for only about 2% of all malignant ovarian neoplasm. The aim of this study was to evaluate the clinicopathologic characteristics, treatment, long-term survival, and fertility outcome of women diagnosed with ovarian dysgerminoma at our institution. Sixty-five women with histologically proven pure ovarian dysgerminoma were identified in this retrospective study. They were treated at King Faisal Specialist Hospital, Riyadh; Saudi Arabia between 1976 and 2010. The median age was 20 years. The most frequent symptoms at presentation were abdominal pain and abdominal/pelvic mass. Thirty-three patients (50.7%) presented with stage I, 2 (3.1%) had stage II, 22 (33.8%) had stage III, and 4 (6.2%) had stage IV (4 unknown stage). Unilateral oophorectomy was performed in 50 patients (76.9%) while bilateral oophorectomy±hysterectomy was done in 12 patients (18.4%). Three patients had biopsy only. Forty patients (61.5%) received only chemotherapy, and 4 patients (6.2%) received radiotherapy alone. Recurrence was observed in 6 patients (9.2%). With median follow-up of 54 months, the 5-year disease-free survival (DFS) and overall survival (OS) were 88 and 95%, respectively. On univariate analysis, adjuvant chemotherapy was independent better prognostic factor for DFS (HR, 0.09; 95% CI, 0.01-0.84; P=0.034). Of the 50 patients treated with fertility-sparing surgery, 16 patients (32%) achieved pregnancy with 14 live births. Patients with pure ovarian dysgerminoma have excellent long-term outcome. There is no difference at outcome between fertility-sparing and nonconservative surgeries. Adjuvant chemotherapy was associated with significant improvement in DFS. It is possible to maintain good reproductive function after conservative surgery followed by chemotherapy in our series.
Topics: Adolescent; Adult; Aged; Dysgerminoma; Female; Humans; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Ovarian Neoplasms
PubMed: 22407668
DOI: 10.1007/s12032-012-0194-z -
Human Pathology Aug 2006Dysgerminoma is a malignant germ cell tumor of the ovary that shares morphological, immunophenotypic, and genetic features with its testicular counterpart, seminoma....
Dysgerminoma is a malignant germ cell tumor of the ovary that shares morphological, immunophenotypic, and genetic features with its testicular counterpart, seminoma. Recent evidence supports the hypothesis that seminoma can differentiate into non-seminomatous germ cell tumor types. The progression of these tumors can be measured by their acquisition of the potential to express cytokeratin intermediate filaments, a characteristic specific to epithelial differentiation. Although testicular seminomas have been widely investigated, little is known about cytokeratin or E-cadherin expression in dysgerminomas. We investigated 26 formalin-fixed, paraffin-embedded ovarian dysgerminomas with immunohistochemical stains for CAM5.2, AE1/AE3, epithelial membrane antigen, cytokeratin 7, cytokeratin 20, high-molecular-weight keratin, and E-cadherin. In addition, we investigated the CD30 and vimentin immunoreactivity of these tumors. Immunoreactivity for CAM5.2 and for AE1/AE3 was present in more than 10% of neoplastic cells in 5 (19.2%) of 26 cases and in 2 (7.7%) of 26 cases, respectively. Cytokeratin 7 showed only focal positivity and never showed positive staining in greater than 10% of dysgerminoma cells. E-cadherin staining was positive in 2 cases showing weak membranous immunostaining in more than 10% of cells. Vimentin immunoreactivity was observed in only 2 dysgerminomas, both of which had less than 10% of the neoplastic cells staining. Cytokeratin 20, epithelial membrane antigen, high-molecular-weight keratin, and CD30 were consistently negative in all cases. Our study demonstrates that cytokeratin expression in dysgerminomas is not unusual and is consistent with the hypothesis that dysgerminomas have the capacity to differentiate along epithelial lines. Furthermore, the immunohistochemical staining patterns for cytokeratins, E-cadherin, and CD30 in dysgerminomas need to be considered when assessing differential diagnoses in difficult cases of primary ovarian tumors.
Topics: Adolescent; Adult; Biomarkers, Tumor; Cell Count; Child; Dysgerminoma; Female; Humans; Immunoenzyme Techniques; Keratins; Ki-1 Antigen; Middle Aged; Ovarian Neoplasms
PubMed: 16867864
DOI: 10.1016/j.humpath.2006.02.018 -
Obstetrics and Gynecology Mar 1979From a review of 26 reported case (our case being the 27th) of dysgerminoma associated with pregnancy, several salient facts are evident. Torsion and incarceration are...
From a review of 26 reported case (our case being the 27th) of dysgerminoma associated with pregnancy, several salient facts are evident. Torsion and incarceration are common among these rapidly enlarging tumors. Obstetrical complications occurred in nearly half and fetal demise in one quarter of the reviewed cases. Our case was typical of patients presenting with this vexed problems: The patient was under 25 (as were 70%); nulliparous (as were 67%); and the tumor appeared confined to one ovary (as in 89%). Authorities are in dispute as to the treatment of stage IA dysgerminomas, and the association of pregnancy complicates this debate even further. The results of conservative treatment in this series were jarring: There were recurrences in 30% of the 23 stage IA tumors, and the recurrences were all following unilateral oophorectomy. In our case, the grossly normal contralateral ovary was infiltrated with dysgerminoma cells. While treatment of a young woman with a dysgerminoma of 1 ovary is a matter of perplexity, we believe that a unilateral operation should be limited to those women who desire above all earthly things to retain their childbearing capacity.
Topics: Adult; Cesarean Section; Dysgerminoma; Female; Humans; Infant, Newborn; Ovarian Neoplasms; Pregnancy; Pregnancy Complications
PubMed: 424104
DOI: No ID Found -
Kansas Medicine : the Journal of the... Jan 1988
Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Drug Administration Schedule; Dysgerminoma; Female; Humans; Pelvic Neoplasms
PubMed: 3343802
DOI: No ID Found -
Obstetrics and Gynecology Mar 1969
Topics: Adolescent; Adult; Age Factors; Castration; Child; Child, Preschool; Dysgerminoma; Female; Humans; Infant; Middle Aged; Ovarian Neoplasms; Pregnancy; Racial Groups
PubMed: 5776086
DOI: No ID Found -
Journal of Surgical Oncology Jan 1991Twenty-seven patients with pure dysgerminoma were seen at the Tata Memorial Hospital, Bombay, between January 1980 and December 1984. Of the 10 patients in stage I, 2...
Twenty-seven patients with pure dysgerminoma were seen at the Tata Memorial Hospital, Bombay, between January 1980 and December 1984. Of the 10 patients in stage I, 2 patients underwent a unilateral salpingoophorectomy (USO) and were kept under observation without any adjuvant therapy, while the remaining patients received adjuvant treatment following surgery. All of the 6 patients in stage II and 4 of 7 in stage III had total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) followed by postoperative radiotherapy. One patient presented in stage IV and 3 patients presented with recurrence after previous definitive treatment undertaken at other institutions. The disease free, as well as the overall survival, at 108 months, for the 24 cases primarily treated at this institution, is 81% and 88% respectively, and, for patients in stages I and II, 100% (Kaplan-Meier estimation). The need for controlled clinical trials to devise optimal therapy in the early clinical stages and use of chemotherapy for advanced stages of this highly curable entity are stressed.
Topics: Adolescent; Adult; Child; Child, Preschool; Combined Modality Therapy; Dysgerminoma; Female; Humans; Infant; Lymphatic Metastasis; Middle Aged; Neoplasm Staging; Ovarian Neoplasms; Predictive Value of Tests; Recurrence; Survival Rate
PubMed: 1986147
DOI: 10.1002/jso.2930460111 -
BMC Pregnancy and Childbirth Sep 2021Ovarian dysgerminoma, a subtype of malignant germ cell tumor (GCT), is a rare ovarian neoplasm that is infrequently found in the gravid patient. When dysgerminomas do...
BACKGROUND
Ovarian dysgerminoma, a subtype of malignant germ cell tumor (GCT), is a rare ovarian neoplasm that is infrequently found in the gravid patient. When dysgerminomas do occur in pregnancy, the rapidly growing tumors can have a heterogeneous presentation and lead to peripartum complications and morbidity. Due to the rarity of this condition, diagnostic and therapeutic strategies are not well described in the literature.
CASE PRESENTATION
A healthy multigravida with an uncomplicated antenatal history presented for elective induction of labor. She had a protracted labor course, persistently abnormal cervical examinations, and eventually developed a worsening Category II tracing that prompted cesarean birth. Intraoperatively, a 26 cm pelvic mass later identified as a Stage IA dysgerminoma was discovered along with a massive hemoperitoneum. The mass was successfully resected, and the patient remains without recurrence 6 months postoperatively.
CONCLUSION
Although rare and generally indolent, dysgerminomas can grow rapidly and cause mechanical obstruction of labor and other complications in pregnancy. Pelvic masses, including malignant neoplasms, should be included in as part of a broad differential diagnosis when evaluating even routine intrapartum complications such as abnormal labor progression. Additionally, we demonstrate that adnexal masses can be a source of life-threatening intraabdominal hemorrhage.
Topics: Adult; Diagnosis, Differential; Dysgerminoma; Dystocia; Female; Hemoperitoneum; Humans; Incidental Findings; Ovarian Neoplasms; Pregnancy; Pregnancy Complications, Neoplastic; Treatment Outcome
PubMed: 34493243
DOI: 10.1186/s12884-021-04063-2 -
Cancer May 2011Dysgerminoma, the ovarian counterpart of seminoma, is the most common type of malignant ovarian germ cell tumor. The role of KIT mutation and amplification in the...
BACKGROUND
Dysgerminoma, the ovarian counterpart of seminoma, is the most common type of malignant ovarian germ cell tumor. The role of KIT mutation and amplification in the development of dysgerminoma is not currently established. The purpose of this study was to analyze alterations of the KIT gene in a large series of dysgerminomas and correlate the findings with clinicopathological parameters.
METHODS
Dysgerminoma cells from 22 patients were analyzed for KIT mutations at exon 17 codon 816. KIT amplification and chromosome 12p anomalies were investigated by way of dual color fluorescence in situ hybridization. KIT protein expression was also examined by way of immunohistochemistry.
RESULTS
KIT exon 17 codon 816 mutations and KIT amplification were each detected in 6 cases of dysgerminoma (27%); however, there was no correlation between these 2 factors. KIT expression was detected in 87% of dysgerminomas. The KIT mutation was associated with advanced pathological stage (P < .05), and KIT amplification was associated with elevated KIT protein expression (P < .05). Chromosome 12p anomalies were found in 82% of the dysgerminomas and did not correlate with KIT abnormalities.
CONCLUSIONS
KIT mutations occur in approximately one-third of cases of dysgerminomas and are associated with advanced stage at presentation. KIT is a potential therapeutic target for those dysgerminomas that have the mutation.
Topics: Adolescent; Adult; Biomarkers, Tumor; Child; Dysgerminoma; Female; Gene Amplification; Humans; Middle Aged; Mutation; Ovarian Neoplasms; Proto-Oncogene Proteins c-kit
PubMed: 21523721
DOI: 10.1002/cncr.25794