Ovarian germ cell tumor natural history: Difference between revisions

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__NOTOC__
__NOTOC__
{{Ovarian germ cell tumor}}
{{Ovarian germ cell tumor}}
{{CMG}}; {{AE}}{{Sahar}}
{{CMG}}; {{AE}} {{Sahar}} {{MD}}


==Overview==
==Overview==
The prognosis of germ cells of the ovary depends on the type of the tumor and its malignant potentials.  
The [[prognosis]] of [[Germ cell|germ cells]] of the [[ovary]] depends on the type of the [[tumor]] and its [[malignant]] potentials. Possible [[complications]] of benign [[Teratoma|teratomas]] are a [[rupture]] and [[ovarian torsion]] also [[malignant transformation]]. [[Prognosis|Prognosi]]<nowiki/>s is generally excellent in the [[Mature cystic teratoma|mature teratoma]], but in case of simultaneous [[malignant transformation]], the 5-year [[survival rate]] of patients is approximately [15-30]%. The 5-year [[survival rate]] of the patient even with [[Disseminated disease|disseminated]] [[dysgerminoma]] at the time of [[diagnosis]] is above 90%. The overall 5-year [[survival rate]] for [[yolk sac tumor]], [[embryonal carcinoma]] and [[choriocarcinoma]] are approximately 80%.
Possible complications of benign teratomas are a rupture and ovarian torsion also malignant transformation.
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].


OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==


===Natural History===
===Natural History===
*The symptoms of ovarian germ cell tumors usually develop in the teenage years with abdominal pain or fullness, and palpable pelvic/abdominal mass.<ref name="LowIlancheran2012">{{cite journal|last1=Low|first1=Jeffrey J.H.|last2=Ilancheran|first2=Arunachalam|last3=Ng|first3=Joseph S.|title=Malignant ovarian germ-cell tumours|journal=Best Practice & Research Clinical Obstetrics & Gynaecology|volume=26|issue=3|year=2012|pages=347–355|issn=15216934|doi=10.1016/j.bpobgyn.2012.01.002}}</ref>
 
Dysgerminomas
*The [[symptoms]] of [[ovarian]] [[germ cell]] [[tumors]] usually develop in the teenage years with [[abdominal pain]] or [[fullness]], and [[palpable]] [[pelvic]]/[[abdominal]] [[mass]].<ref name="LowIlancheran2012">{{cite journal|last1=Low|first1=Jeffrey J.H.|last2=Ilancheran|first2=Arunachalam|last3=Ng|first3=Joseph S.|title=Malignant ovarian germ-cell tumours|journal=Best Practice & Research Clinical Obstetrics & Gynaecology|volume=26|issue=3|year=2012|pages=347–355|issn=15216934|doi=10.1016/j.bpobgyn.2012.01.002}}</ref>
*These tumors tend to spread late and do so through lymphatic system primarily.<ref name="ShaabanRezvani2014">{{cite journal|last1=Shaaban|first1=Akram M.|last2=Rezvani|first2=Maryam|last3=Elsayes|first3=Khaled M.|last4=Baskin|first4=Henry|last5=Mourad|first5=Amr|last6=Foster|first6=Bryan R.|last7=Jarboe|first7=Elke A.|last8=Menias|first8=Christine O.|title=Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features|journal=RadioGraphics|volume=34|issue=3|year=2014|pages=777–801|issn=0271-5333|doi=10.1148/rg.343130067}}</ref>
[[Dysgerminoma|Dysgerminomas]]
Yolk sac tumor
*[[Dysgerminoma]] may be misdiagnosed with [[ectopic pregnancy]] given the presence of [[Pelvic masses|pelvic mass]] accompanied with high [[serum]] concentrations of B-[[hCG]].<ref name="pmid22669919">{{cite journal| author=Rozenholc A, Abdulcadir J, Pelte MF, Petignat P| title=A pelvic mass on ultrasonography and high human chorionic gonadotropin level: not always an ectopic pregnancy. | journal=BMJ Case Rep | year= 2012 | volume= 2012 | issue=  | pages=  | pmid=22669919 | doi=10.1136/bcr.01.2012.5577 | pmc=4543203 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22669919  }} </ref>
*These tumors tend to grow rapidly and spread to abdominopelvic cavity in early stages.<ref name="SteinWasnik2017">{{cite journal|last1=Stein|first1=Erica B.|last2=Wasnik|first2=Ashish P.|last3=Sciallis|first3=Andrew P.|last4=Kamaya|first4=Aya|last5=Maturen|first5=Katherine E.|title=MR Imaging–Pathologic Correlation in Ovarian Cancer|journal=Magnetic Resonance Imaging Clinics of North America|volume=25|issue=3|year=2017|pages=545–562|issn=10649689|doi=10.1016/j.mric.2017.03.004}}</ref>
*These [[tumors]] tend to [[Spread of the cancer|spread]] late and do so through [[lymphatic system]] primarily.<ref name="ShaabanRezvani2014">{{cite journal|last1=Shaaban|first1=Akram M.|last2=Rezvani|first2=Maryam|last3=Elsayes|first3=Khaled M.|last4=Baskin|first4=Henry|last5=Mourad|first5=Amr|last6=Foster|first6=Bryan R.|last7=Jarboe|first7=Elke A.|last8=Menias|first8=Christine O.|title=Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features|journal=RadioGraphics|volume=34|issue=3|year=2014|pages=777–801|issn=0271-5333|doi=10.1148/rg.343130067}}</ref>
*They are mostly affects women in theie second or third decade of life.<ref name="pmid63318">{{cite journal |vauthors=Kurman RJ, Norris HJ |title=Endodermal sinus tumor of the ovary: a clinical and pathologic analysis of 71 cases |journal=Cancer |volume=38 |issue=6 |pages=2404–19 |date=December 1976 |pmid=63318 |doi= |url=}}</ref>
[[Yolk sac tumor]]
Embryonal carcinoma
*These [[tumors]] tend to grow rapidly and [[Spread of the cancer|spread]] to [[abdominal]]/[[pelvic]] [[cavity]] in early stages.<ref name="SteinWasnik2017">{{cite journal|last1=Stein|first1=Erica B.|last2=Wasnik|first2=Ashish P.|last3=Sciallis|first3=Andrew P.|last4=Kamaya|first4=Aya|last5=Maturen|first5=Katherine E.|title=MR Imaging–Pathologic Correlation in Ovarian Cancer|journal=Magnetic Resonance Imaging Clinics of North America|volume=25|issue=3|year=2017|pages=545–562|issn=10649689|doi=10.1016/j.mric.2017.03.004}}</ref>
*These tumors tend to metastasize early.<ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref>
*They are mostly affects women in their second or third decade of life.<ref name="pmid63318">{{cite journal |vauthors=Kurman RJ, Norris HJ |title=Endodermal sinus tumor of the ovary: a clinical and pathologic analysis of 71 cases |journal=Cancer |volume=38 |issue=6 |pages=2404–19 |date=December 1976 |pmid=63318 |doi= |url=}}</ref>
*They spread through the lymphatic system.
[[Embryonal carcinoma]]
Choriocarcinoma
*These [[tumors]] tend to [[metastasize]] early.<ref name="pmid12733128">{{cite journal |vauthors=Chen VW, Ruiz B, Killeen JL, Coté TR, Wu XC, Correa CN |title=Pathology and classification of ovarian tumors |journal=Cancer |volume=97 |issue=10 Suppl |pages=2631–42 |date=May 2003 |pmid=12733128 |doi=10.1002/cncr.11345 |url=}}</ref>
*These tumors are highly malignant and tend to spread locally and within the abdominal cavity.<ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref>
*They spread through the [[lymphatic system]].
*They spread early in the course of the tumor.
[[Choriocarcinoma]]
*Non-gestational choriocarcinomas spread through lymphatic system.
*These [[tumors]] are highly [[malignant]] and tend to spread locally and within the [[abdominal]] [[cavity]].<ref name="pmid12733128">{{cite journal |vauthors=Chen VW, Ruiz B, Killeen JL, Coté TR, Wu XC, Correa CN |title=Pathology and classification of ovarian tumors |journal=Cancer |volume=97 |issue=10 Suppl |pages=2631–42 |date=May 2003 |pmid=12733128 |doi=10.1002/cncr.11345 |url=}}</ref>
*Gestational choriocarcinomas spread through Bloodstream.
*They [[Spread of the cancer|spread]] early in the course of the [[tumor]].
*Non-[[Gestation period|gestational]] [[Choriocarcinoma|choriocarcinomas]] spread through [[lymphatic system]].
*[[Gestational choriocarcinoma|Gestational choriocarcinomas]] spread through [[Bloodstream]].
===Complications===
===Complications===
===Mature teratoma===
===Mature teratoma===
Common complications of mature teratoma include:<ref name="AyhanBukulmez2000">{{cite journal|last1=Ayhan|first1=Ali|last2=Bukulmez|first2=Orhan|last3=Genc|first3=Cuneyt|last4=Karamursel|first4=Burcu S.|last5=Ayhan|first5=Ayse|title=Mature cystic teratomas of the ovary: case series from one institution over 34 years|journal=European Journal of Obstetrics & Gynecology and Reproductive Biology|volume=88|issue=2|year=2000|pages=153–157|issn=03012115|doi=10.1016/S0301-2115(99)00141-4}}</ref>
Common [[complications]] of [[Mature cystic teratoma|mature teratoma]] include:<ref name="AyhanBukulmez2000">{{cite journal|last1=Ayhan|first1=Ali|last2=Bukulmez|first2=Orhan|last3=Genc|first3=Cuneyt|last4=Karamursel|first4=Burcu S.|last5=Ayhan|first5=Ayse|title=Mature cystic teratomas of the ovary: case series from one institution over 34 years|journal=European Journal of Obstetrics & Gynecology and Reproductive Biology|volume=88|issue=2|year=2000|pages=153–157|issn=03012115|doi=10.1016/S0301-2115(99)00141-4}}</ref>
*Ovarian torsion is the most common complication and affects 5% to 10% of the individuals.
*[[Ovarian torsion]] is the most common [[Complications|complication]] and affects 5% to 10% of the individuals.
**It happens at a greater extent in:<ref name="KimKim2011">{{cite journal|last1=Kim|first1=Min Jae|last2=Kim|first2=Na Young|last3=Lee|first3=Dong-Yun|last4=Yoon|first4=Byung-Koo|last5=Choi|first5=DooSeok|title=Clinical characteristics of ovarian teratoma: age-focused retrospective analysis of 580 cases|journal=American Journal of Obstetrics and Gynecology|volume=205|issue=1|year=2011|pages=32.e1–32.e4|issn=00029378|doi=10.1016/j.ajog.2011.02.044}}</ref>
**It happens at a greater extent in:<ref name="KimKim2011">{{cite journal|last1=Kim|first1=Min Jae|last2=Kim|first2=Na Young|last3=Lee|first3=Dong-Yun|last4=Yoon|first4=Byung-Koo|last5=Choi|first5=DooSeok|title=Clinical characteristics of ovarian teratoma: age-focused retrospective analysis of 580 cases|journal=American Journal of Obstetrics and Gynecology|volume=205|issue=1|year=2011|pages=32.e1–32.e4|issn=00029378|doi=10.1016/j.ajog.2011.02.044}}</ref>
***Younger age (10-19 years)
***Younger [[age]] (10-19 years)
***Larger tumors
***Larger [[tumors]]
*Rupture in < 4% of the affected individuals.<ref name="AyhanBukulmez2000">{{cite journal|last1=Ayhan|first1=Ali|last2=Bukulmez|first2=Orhan|last3=Genc|first3=Cuneyt|last4=Karamursel|first4=Burcu S.|last5=Ayhan|first5=Ayse|title=Mature cystic teratomas of the ovary: case series from one institution over 34 years|journal=European Journal of Obstetrics & Gynecology and Reproductive Biology|volume=88|issue=2|year=2000|pages=153–157|issn=03012115|doi=10.1016/S0301-2115(99)00141-4}}</ref>
*[[Rupture]] in < 4% of the affected individuals.<ref name="AyhanBukulmez2000">{{cite journal|last1=Ayhan|first1=Ali|last2=Bukulmez|first2=Orhan|last3=Genc|first3=Cuneyt|last4=Karamursel|first4=Burcu S.|last5=Ayhan|first5=Ayse|title=Mature cystic teratomas of the ovary: case series from one institution over 34 years|journal=European Journal of Obstetrics & Gynecology and Reproductive Biology|volume=88|issue=2|year=2000|pages=153–157|issn=03012115|doi=10.1016/S0301-2115(99)00141-4}}</ref>
**Rupture may be associated with leakage of sebaceous contents of the tumor into the peritoneal cavity and leads to granulomatous peritonitis.<ref name="pmid8008317">{{cite journal |vauthors=Comerci JT, Licciardi F, Bergh PA, Gregori C, Breen JL |title=Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature |journal=Obstet Gynecol |volume=84 |issue=1 |pages=22–8 |date=July 1994 |pmid=8008317 |doi= |url=}}</ref>
**[[Rupture]] may be associated with leakage of [[sebaceous]] contents of the [[tumor]] into the [[peritoneal cavity]] and leads to [[granulomatous]] [[peritonitis]].<ref name="pmid8008317">{{cite journal |vauthors=Comerci JT, Licciardi F, Bergh PA, Gregori C, Breen JL |title=Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature |journal=Obstet Gynecol |volume=84 |issue=1 |pages=22–8 |date=July 1994 |pmid=8008317 |doi= |url=}}</ref>
***This complication is very rere and happens in less than 1% of the affected individuals.
**This [[complication]] is very [[rare]] and happens in less than 1% of the affected individuals.
*This tumor may be bilateral in 8% to 15% of cases.
*[[Malignant transformation]] of the [[tumor]] may also happen in approximately 2% of affected individuals.<ref name="pmid2841767">{{cite journal |vauthors=Singh P, Yordan EL, Wilbanks GD, Miller AW, Wee A |title=Malignancy associated with benign cystic teratomas (dermoid cysts) of the ovary |journal=Singapore Med J |volume=29 |issue=1 |pages=30–4 |date=February 1988 |pmid=2841767 |doi= |url=}}</ref>
*Malignant transformation of the tumor may also happen in approximately 2% of affected individuals.<ref name="pmid2841767">{{cite journal |vauthors=Singh P, Yordan EL, Wilbanks GD, Miller AW, Wee A |title=Malignancy associated with benign cystic teratomas (dermoid cysts) of the ovary |journal=Singapore Med J |volume=29 |issue=1 |pages=30–4 |date=February 1988 |pmid=2841767 |doi= |url=}}</ref>
**The [[tumor]] undergoes [[malignant transformation]] to [[squamous cell carcinoma]] in 80% of them and to [[adenocarcinoma]] in the rest of the cases.
**The tumor undergoes malignant transformation to squamous cell carcinma in 80% of them and to adenocarcinoma in the rest of the cases.
===Dysgerminoma===
===Dysgerminoma===
* Ovarian torsion and acute abdominal pain may occur in < 10% of the cases.<ref name="pmid22407668">{{cite journal |vauthors=A L Husaini H, Soudy H, El Din Darwish A, Ahmed M, Eltigani A, A L Mubarak M, Sabaa AA, Edesa W, A L-Tweigeri T, Al-Badawi IA |title=Pure dysgerminoma of the ovary: a single institutional experience of 65 patients |journal=Med. Oncol. |volume=29 |issue=4 |pages=2944–8 |date=December 2012 |pmid=22407668 |doi=10.1007/s12032-012-0194-z |url=}}</ref>
* [[Ovarian torsion]] and [[acute abdominal pain]] may occur in < 10% of the cases.<ref name="AL HusainiSoudy2012">{{cite journal|last1=AL Husaini|first1=Hamed|last2=Soudy|first2=Hussein|last3=Darwish|first3=Alaa El Din|last4=Ahmed|first4=Mohamed|last5=Eltigani|first5=Amin|last6=AL Mubarak|first6=Mustafa|last7=Sabaa|first7=Amal Abu|last8=Edesa|first8=Wael|last9=AL-Tweigeri|first9=Taher|last10=Al-Badawi|first10=Ismail A.|title=Pure dysgerminoma of the ovary: a single institutional experience of 65 patients|journal=Medical Oncology|volume=29|issue=4|year=2012|pages=2944–2948|issn=1357-0560|doi=10.1007/s12032-012-0194-z}}</ref>
*
 
===Prognosis===
===Prognosis===
* Only 3% to 5% of ovarian germ cell tumors are malignant which the majority include:<ref name="SmithBerwick2006">{{cite journal|last1=Smith|first1=Harriet O.|last2=Berwick|first2=Marianne|last3=Verschraegen|first3=Claire F.|last4=Wiggins|first4=Charles|last5=Lansing|first5=Letitia|last6=Muller|first6=Carolyn Y.|last7=Qualls|first7=Clifford R.|title=Incidence and Survival Rates for Female Malignant Germ Cell Tumors|journal=Obstetrics & Gynecology|volume=107|issue=5|year=2006|pages=1075–1085|issn=0029-7844|doi=10.1097/01.AOG.0000216004.22588.ce}}</ref>
* Only 3% to 5% of [[ovarian]] [[germ cell]] [[tumors]] are [[malignant]] which the majority include:<ref name="SmithBerwick2006">{{cite journal|last1=Smith|first1=Harriet O.|last2=Berwick|first2=Marianne|last3=Verschraegen|first3=Claire F.|last4=Wiggins|first4=Charles|last5=Lansing|first5=Letitia|last6=Muller|first6=Carolyn Y.|last7=Qualls|first7=Clifford R.|title=Incidence and Survival Rates for Female Malignant Germ Cell Tumors|journal=Obstetrics & Gynecology|volume=107|issue=5|year=2006|pages=1075–1085|issn=0029-7844|doi=10.1097/01.AOG.0000216004.22588.ce}}</ref>
** Dysgerminomas
** [[Dysgerminoma|Dysgerminomas]]
** Immature teratomas
** Immature [[teratoma]]
** Yolk sac tumors
** [[Yolk sac tumor]]
*** Pure form
*** Pure form
*** Part of a mixed germ cell tumor
*** Part of a mixed [[germ cell]] [[tumor]]


===Mature teratoma===
{| class="wikitable"
*Prognosis is generally excellent in the mature teratoma, but in case of simultaneous malignant transformation, the 5-year survival rate of patients is approximately [15-30]%.<ref name="ParkKim2008">{{cite journal|last1=Park|first1=Jeong-Yeol|last2=Kim|first2=Dae-Yeon|last3=Kim|first3=Jong-Hyeok|last4=Kim|first4=Yong-Man|last5=Kim|first5=Young-Tak|last6=Nam|first6=Joo-Hyun|title=Malignant transformation of mature cystic teratoma of the ovary: Experience at a single institution|journal=European Journal of Obstetrics & Gynecology and Reproductive Biology|volume=141|issue=2|year=2008|pages=173–178|issn=03012115|doi=10.1016/j.ejogrb.2008.07.032}}</ref>
|+
===Immature teratoma===
! colspan="2" |Prognosis of ovarian germ cell tumors
The prognosis of immature teratoma is favorable.<ref name="urlHarvardKey Login">{{cite web |url=https://www-sciencedirect-com.ezp-prod1.hul.harvard.edu/book/9780323447324/diagnostic-gynecologic-and-obstetric-pathology |title=HarvardKey Login |format= |work= |accessdate=}}</ref>
|-
*The overall 5-year survival rate is 90%.
|Mature teratoma
*The 5-yr survival for stages III and IV is 75%.
|[[Prognosis]] is generally excellent in the [[Mature cystic teratoma|mature teratoma]], but in case of simultaneous [[malignant transformation]], the 5-year [[survival rate]] of patients is approximately [15-30]%.<ref name="ParkKim2008">{{cite journal|last1=Park|first1=Jeong-Yeol|last2=Kim|first2=Dae-Yeon|last3=Kim|first3=Jong-Hyeok|last4=Kim|first4=Yong-Man|last5=Kim|first5=Young-Tak|last6=Nam|first6=Joo-Hyun|title=Malignant transformation of mature cystic teratoma of the ovary: Experience at a single institution|journal=European Journal of Obstetrics & Gynecology and Reproductive Biology|volume=141|issue=2|year=2008|pages=173–178|issn=03012115|doi=10.1016/j.ejogrb.2008.07.032}}</ref>
*Relapse rate is 20% for grade III tumors.
|-
===Dysgerminoma===
|Immature teratoma
*Depending on the stage of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.<ref name="VicusBeiner2010">{{cite journal|last1=Vicus|first1=Danielle|last2=Beiner|first2=Mario E.|last3=Klachook|first3=Shany|last4=Le|first4=Lisa W.|last5=Laframboise|first5=Stephane|last6=Mackay|first6=Helen|title=Pure dysgerminoma of the ovary 35 years on: A single institutional experience|journal=Gynecologic Oncology|volume=117|issue=1|year=2010|pages=23–26|issn=00908258|doi=10.1016/j.ygyno.2009.12.024}}</ref>
|The [[prognosis]] of immature [[teratoma]] is favorable.<ref name="urlHarvardKey Login">{{cite web |url=https://www-sciencedirect-com.ezp-prod1.hul.harvard.edu/book/9780323447324/diagnostic-gynecologic-and-obstetric-pathology |title=HarvardKey Login |format= |work= |accessdate=}}</ref>
*The 5-year survival rate of the patient even with disseminated disease at the time of diagnosis is above 90%.
*The overall 5-year [[survival rate]] is 90%.
*Reoccurence of the tumor may occur within 2-years of diagnosis and is curable.
*The 5-year [[Survival rate|survival]] for stages III and IV is 75%.
*[[Relapse|Relapse rate]] is 20% for grade III [[Tumor|tumors]].
|-
|Dysgerminoma
|
*Depending on the stage of the [[tumor]] at the time of [[diagnosis]], the [[prognosis]] may vary. However, the [[prognosis]] is generally regarded as good.<ref name="VicusBeiner2010">{{cite journal|last1=Vicus|first1=Danielle|last2=Beiner|first2=Mario E.|last3=Klachook|first3=Shany|last4=Le|first4=Lisa W.|last5=Laframboise|first5=Stephane|last6=Mackay|first6=Helen|title=Pure dysgerminoma of the ovary 35 years on: A single institutional experience|journal=Gynecologic Oncology|volume=117|issue=1|year=2010|pages=23–26|issn=00908258|doi=10.1016/j.ygyno.2009.12.024}}</ref>
*The 5-year [[survival rate]] of the patient even with disseminated [[disease]] at the time of [[diagnosis]] is above 90%.
*Recurrence of the [[tumor]] may occur within 2-years of [[diagnosis]] and is curable.
**For stage A1 the recurrence rate is approximately 20% in 2-years.
**For stage A1 the recurrence rate is approximately 20% in 2-years.
*Poor prognosis is associated with the following factors:<ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref>
*Poor [[prognosis]] is associated with the following factors:<ref name="pmid12733128" />
**Large tumor size
**Large [[tumor]] size
**Bilateral involvement
**[[Bilateral]] involvement
**Age< 20 or > 40 years
**Age< 20 or > 40 years
**Presence of other germ cell neoplasms
**Presence of other [[germ cell]] [[neoplasms]]
 
|-
===Yolk sac tumor===
|Yolk sac tumor
*These tumors are highly malignant and tend to spread early.<ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref>
|
*The survival rate depends on the stage of the tumor:
*These [[Tumor|tumors]] are highly [[malignant]] and tend to spread early.<ref name="pmid12733128" />
*The [[survival rate]] depends on the stage of the [[tumor]]:
**For Stage I–II is 60–100%
**For Stage I–II is 60–100%
**For Stage III–IV disease is 50–75% after appropriate chemotherapy.
**For Stage III–IV disease is 50–75% after appropriate [[chemotherapy]].
*The overall 5-year survival rate is 80%.<ref name="urlHarvardKey Login">{{cite web |url=https://www-sciencedirect-com.ezp-prod1.hul.harvard.edu/book/9780323447324/diagnostic-gynecologic-and-obstetric-pathology |title=HarvardKey Login |format= |work= |accessdate=}}</ref>
*The overall 5-year [[survival rate]] is 80%.<ref name="urlHarvardKey Login" />
*Relapse rate is 20% overall.
*[[Relapse]] rate is 20% overall.
===Embryonal carcinoma===
|-
*These tumors tend to metastasize early.<ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref>
|Embryonal carcinoma
*The survival rate is simmilar to yolk sac tumor.
|
===Choriocarcinoma===
*These [[Tumor|tumors]] tend to [[metastasize]] early.<ref name="pmid12733128" />
*These tumors are highly malignant and tend to spread locally and within the abdominal cavity.<ref name="ChenRuiz2003">{{cite journal|last1=Chen|first1=Vivien W.|last2=Ruiz|first2=Bernardo|last3=Killeen|first3=Jeffrey L.|last4=Cot�|first4=Timothy R.|last5=Wu|first5=Xiao Cheng|last6=Correa|first6=Catherine N.|last7=Howe|first7=Holly L.|title=Pathology and classification of ovarian tumors|journal=Cancer|volume=97|issue=S10|year=2003|pages=2631–2642|issn=0008-543X|doi=10.1002/cncr.11345}}</ref>
*The [[survival rate]] is similar to [[yolk sac tumor]].
*They spread early in the course of the tumor.
|-
*Survival rate is improved with combination chemotheraspy.
|Choriocarcinoma
*The majority of patients do not experience the reocurrence except those with non-gestational choriocarcinoma.
|
*The overall 5-year survival rate is 80%.<ref name="urlHarvardKey Login">{{cite web |url=https://www-sciencedirect-com.ezp-prod1.hul.harvard.edu/book/9780323447324/diagnostic-gynecologic-and-obstetric-pathology |title=HarvardKey Login |format= |work= |accessdate=}}</ref>
*These [[tumors]] are highly [[malignant]] and tend to spread locally and within the [[abdominal cavity]].<ref name="pmid12733128" />
*Relapse rate is 20% overall.
*They [[Spread of the cancer|spread]] early in the course of the [[tumor]].
*[[Survival rate]] is improved with combination [[chemotherapy]].
*The majority of patients do not experience the recurrence except those with non-[[Gestation period|gestational]] [[choriocarcinoma]].
*The overall 5-year [[survival rate]] is 80%.<ref name="urlHarvardKey Login" />
*[[Relapse]] rate is 20% overall.
|}


==References==
==References==

Latest revision as of 13:50, 22 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Monalisa Dmello, M.B,B.S., M.D. [3]

Overview

The prognosis of germ cells of the ovary depends on the type of the tumor and its malignant potentials. Possible complications of benign teratomas are a rupture and ovarian torsion also malignant transformation. Prognosis is generally excellent in the mature teratoma, but in case of simultaneous malignant transformation, the 5-year survival rate of patients is approximately [15-30]%. The 5-year survival rate of the patient even with disseminated dysgerminoma at the time of diagnosis is above 90%. The overall 5-year survival rate for yolk sac tumor, embryonal carcinoma and choriocarcinoma are approximately 80%.

Natural History, Complications, and Prognosis

Natural History

Dysgerminomas

Yolk sac tumor

Embryonal carcinoma

Choriocarcinoma

Complications

Mature teratoma

Common complications of mature teratoma include:[7]

Dysgerminoma

Prognosis

Prognosis of ovarian germ cell tumors
Mature teratoma Prognosis is generally excellent in the mature teratoma, but in case of simultaneous malignant transformation, the 5-year survival rate of patients is approximately [15-30]%.[13]
Immature teratoma The prognosis of immature teratoma is favorable.[14]
Dysgerminoma
Yolk sac tumor
Embryonal carcinoma
Choriocarcinoma

References

  1. ↑ Low, Jeffrey J.H.; Ilancheran, Arunachalam; Ng, Joseph S. (2012). "Malignant ovarian germ-cell tumours". Best Practice & Research Clinical Obstetrics & Gynaecology. 26 (3): 347–355. doi:10.1016/j.bpobgyn.2012.01.002. ISSN 1521-6934.
  2. ↑ Rozenholc A, Abdulcadir J, Pelte MF, Petignat P (2012). "A pelvic mass on ultrasonography and high human chorionic gonadotropin level: not always an ectopic pregnancy". BMJ Case Rep. 2012. doi:10.1136/bcr.01.2012.5577. PMC 4543203. PMID 22669919.
  3. ↑ Shaaban, Akram M.; Rezvani, Maryam; Elsayes, Khaled M.; Baskin, Henry; Mourad, Amr; Foster, Bryan R.; Jarboe, Elke A.; Menias, Christine O. (2014). "Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features". RadioGraphics. 34 (3): 777–801. doi:10.1148/rg.343130067. ISSN 0271-5333.
  4. ↑ Stein, Erica B.; Wasnik, Ashish P.; Sciallis, Andrew P.; Kamaya, Aya; Maturen, Katherine E. (2017). "MR Imaging–Pathologic Correlation in Ovarian Cancer". Magnetic Resonance Imaging Clinics of North America. 25 (3): 545–562. doi:10.1016/j.mric.2017.03.004. ISSN 1064-9689.
  5. ↑ Kurman RJ, Norris HJ (December 1976). "Endodermal sinus tumor of the ovary: a clinical and pathologic analysis of 71 cases". Cancer. 38 (6): 2404–19. PMID 63318.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 Chen VW, Ruiz B, Killeen JL, Coté TR, Wu XC, Correa CN (May 2003). "Pathology and classification of ovarian tumors". Cancer. 97 (10 Suppl): 2631–42. doi:10.1002/cncr.11345. PMID 12733128.
  7. ↑ 7.0 7.1 Ayhan, Ali; Bukulmez, Orhan; Genc, Cuneyt; Karamursel, Burcu S.; Ayhan, Ayse (2000). "Mature cystic teratomas of the ovary: case series from one institution over 34 years". European Journal of Obstetrics & Gynecology and Reproductive Biology. 88 (2): 153–157. doi:10.1016/S0301-2115(99)00141-4. ISSN 0301-2115.
  8. ↑ Kim, Min Jae; Kim, Na Young; Lee, Dong-Yun; Yoon, Byung-Koo; Choi, DooSeok (2011). "Clinical characteristics of ovarian teratoma: age-focused retrospective analysis of 580 cases". American Journal of Obstetrics and Gynecology. 205 (1): 32.e1–32.e4. doi:10.1016/j.ajog.2011.02.044. ISSN 0002-9378.
  9. ↑ Comerci JT, Licciardi F, Bergh PA, Gregori C, Breen JL (July 1994). "Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature". Obstet Gynecol. 84 (1): 22–8. PMID 8008317.
  10. ↑ Singh P, Yordan EL, Wilbanks GD, Miller AW, Wee A (February 1988). "Malignancy associated with benign cystic teratomas (dermoid cysts) of the ovary". Singapore Med J. 29 (1): 30–4. PMID 2841767.
  11. ↑ AL Husaini, Hamed; Soudy, Hussein; Darwish, Alaa El Din; Ahmed, Mohamed; Eltigani, Amin; AL Mubarak, Mustafa; Sabaa, Amal Abu; Edesa, Wael; AL-Tweigeri, Taher; Al-Badawi, Ismail A. (2012). "Pure dysgerminoma of the ovary: a single institutional experience of 65 patients". Medical Oncology. 29 (4): 2944–2948. doi:10.1007/s12032-012-0194-z. ISSN 1357-0560.
  12. ↑ Smith, Harriet O.; Berwick, Marianne; Verschraegen, Claire F.; Wiggins, Charles; Lansing, Letitia; Muller, Carolyn Y.; Qualls, Clifford R. (2006). "Incidence and Survival Rates for Female Malignant Germ Cell Tumors". Obstetrics & Gynecology. 107 (5): 1075–1085. doi:10.1097/01.AOG.0000216004.22588.ce. ISSN 0029-7844.
  13. ↑ Park, Jeong-Yeol; Kim, Dae-Yeon; Kim, Jong-Hyeok; Kim, Yong-Man; Kim, Young-Tak; Nam, Joo-Hyun (2008). "Malignant transformation of mature cystic teratoma of the ovary: Experience at a single institution". European Journal of Obstetrics & Gynecology and Reproductive Biology. 141 (2): 173–178. doi:10.1016/j.ejogrb.2008.07.032. ISSN 0301-2115.
  14. ↑ 14.0 14.1 14.2 "HarvardKey Login".
  15. ↑ Vicus, Danielle; Beiner, Mario E.; Klachook, Shany; Le, Lisa W.; Laframboise, Stephane; Mackay, Helen (2010). "Pure dysgerminoma of the ovary 35 years on: A single institutional experience". Gynecologic Oncology. 117 (1): 23–26. doi:10.1016/j.ygyno.2009.12.024. ISSN 0090-8258.
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