Ovarian germ cell tumor pathophysiology: Difference between revisions
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==Gross Pathology== | ==Gross Pathology== | ||
{| {{table}} | {| {{table}} | ||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|''' Ovarian germ cell tumor subtype'''}} | | align="center" style="background: #4479BA;" | {{fontcolor|#FFF|''' Ovarian germ cell tumor subtype'''}} | ||
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| '''Teratoma'''|| | | '''Teratoma'''|| | ||
'''Teratoma-mature''' | '''Teratoma-mature''' | ||
* | * The majority are 5 to 10 cm in diameter.<ref name="Yayla AbideBostancı Ergen2018">{{cite journal|last1=Yayla Abide|first1=Çiğdem|last2=Bostancı Ergen|first2=Evrim|title=Retrospective analysis of mature cystic teratomas in a single center and review of the literature|journal=Journal of Turkish Society of Obstetric and Gynecology|volume=15|issue=2|year=2018|pages=95–98|issn=1307699X|doi=10.4274/tjod.86244}}</ref> | ||
* Cystic content may contain | * Unilocular in the magority of cases (88%) | ||
* Solid or cystic | |||
* Cystic content may contain sebaseous material that is semiliquide in room temperature | |||
* Teeth may be found in Rokitansky’s protuberance - a well-defined, nipple-like structure covered with hair | * Teeth may be found in Rokitansky’s protuberance - a well-defined, nipple-like structure covered with hair | ||
'''Teratoma-immature''' | '''Teratoma-immature''' | ||
* | * Usually appear larger than mature teratomas<ref name="OutwaterSiegelman2001">{{cite journal|last1=Outwater|first1=Eric K.|last2=Siegelman|first2=Evan S.|last3=Hunt|first3=Jennifer L.|title=Ovarian Teratomas: Tumor Types and Imaging Characteristics|journal=RadioGraphics|volume=21|issue=2|year=2001|pages=475–490|issn=0271-5333|doi=10.1148/radiographics.21.2.g01mr09475}}</ref> | ||
* May be solid or with a prominent solid element | |||
* Cystic cavities may be filled with serous or mucinous or fatty-sebaceous fluide. | |||
* Ths capsular component may not always be well-defined | |||
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**Pituitary tissues, although not commonly.<ref name="KallenbergPesce1991">{{cite journal|last1=Kallenberg|first1=GA|last2=Pesce|first2=CM|last3=Norman|first3=B|last4=Ratner|first4=RE|last5=Silverberg|first5=SG|title=Ectopic hyperprolactinemia resulting from an ovarian teratoma|journal=International Journal of Gynecology & Obstetrics|volume=34|issue=2|year=1991|pages=194–195|issn=00207292|doi=10.1016/0020-7292(91)90266-8}}</ref> | **Pituitary tissues, although not commonly.<ref name="KallenbergPesce1991">{{cite journal|last1=Kallenberg|first1=GA|last2=Pesce|first2=CM|last3=Norman|first3=B|last4=Ratner|first4=RE|last5=Silverberg|first5=SG|title=Ectopic hyperprolactinemia resulting from an ovarian teratoma|journal=International Journal of Gynecology & Obstetrics|volume=34|issue=2|year=1991|pages=194–195|issn=00207292|doi=10.1016/0020-7292(91)90266-8}}</ref> | ||
***Rarely, they produce prolactin and is associated with prolactinoma. | ***Rarely, they produce prolactin and is associated with prolactinoma. | ||
==References== | ==References== | ||
Revision as of 16:20, 28 February 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]
Overveiw
The pathophysiology of ovarian germ cell tumors depends on the histological subtype. However, their origin is the primordial germ cells that transformed pathologically in different stages of development.
Pathophysiology
Physiology
The normal physiology of [name of process] can be understood as follows:
Pathogenesis
- The exact pathogenesis of or is not completely understood.
OR
- It is understood that ovarian germ cell tumors are the result of the pathologic transformation of primordial germ cells during different stages of the development.[1]
Mature teratoma
- Mature teratomas are benign tumors originating from pathologic development of primordial germ cells.[2]
- It originates from a single germ cell tumor after the first phase of meiosis.[3]
- These tumors contain the well-differentiated component of three germ layers.[2]
- Their usual location is the embryonic fusion line overhead and neck, mediastinum, a and presacral area and tend to present at a greater extent in the midline.
Dysgerminoma
- Dysgerminoma arises from primordial germ cells, which are gonadal cells that are normally involved in the gametogenesis.[1]
- The progression to [disease name] usually involves the [molecular pathway].
- The pathophysiology of [disease/malignancy] depends on the histological subtype.
Genetics
[Disease name] is transmitted in [mode of genetic transmission] pattern.
OR
Genes involved in the pathogenesis of [disease name] include:
- [Gene1]
- [Gene2]
- [Gene3]
OR
The development of [disease name] is the result of multiple genetic mutations such as:
- [Mutation 1]
- [Mutation 2]
- [Mutation 3]
Associated Conditions
Conditions associated with mature teratoma include:
- Anti-NMDA receptor encephalitis (although very rarely)[4]
- [Condition 2]
- [Condition 3]
Gross Pathology
On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
Gross Pathology
| Ovarian germ cell tumor subtype | Features on Gross Pathology |
| Dysgerminoma |
|
| Endodermal sinus tumor or yolk sac tumors |
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| Embryonal Carcinoma |
|
| Teratoma |
Teratoma-mature
Teratoma-immature
|
Microscopic Pathology
| Ovarian germ cell tumor subtype | Features on Histopathological Microscopic Analysis | Image |
| Dysgerminomas |
|
 |
| Endodermal sinus tumor or yolk sac tumors |
|
|
| Embryonal carcinoma |
Main features:[7]
Additional features that are often mixed:
|
 |
| Teratoma |
Mature teratoma
Immature teratoma
|
 |
Mature teratoma
- It appears as a well-established organization of tissues mimicking the relationship observed in normal organs such as:[13]
- respiratory epithelial layer surrounded by smooth muscle and cartilage
- Usually, there is scant mitosis in the tumor cells usually limited to the normal proliferative zone of the body part that they produce.
- No cytologic atypia is present.
- Different type of tissues may be observed in the mature teratomas of the ovary such as:
- Choroid plexus
- Thyroid tissues
- Pituitary tissues, although not commonly.[14]
- Rarely, they produce prolactin and is associated with prolactinoma.
References
- ↑ 1.0 1.1 El-Maarri, Osman; Rijlaarsdam, Martin A.; Tax, David M. J.; Gillis, Ad J. M.; Dorssers, Lambert C. J.; Koestler, Devin C.; de Ridder, Jeroen; Looijenga, Leendert H. J. (2015). "Genome Wide DNA Methylation Profiles Provide Clues to the Origin and Pathogenesis of Germ Cell Tumors". PLOS ONE. 10 (4): e0122146. doi:10.1371/journal.pone.0122146. ISSN 1932-6203.
- ↑ 2.0 2.1 Vural, F.; Vural, B.; Paksoy, N. (2015). "Vaginal teratoma: A case report and review of the literature". Journal of Obstetrics and Gynaecology. 35 (7): 757–758. doi:10.3109/01443615.2015.1004525. ISSN 0144-3615.
- ↑ Linder, David; McCaw, Barbara Kaiser; Hecht, Frederick (1975). "Parthenogenic Origin of Benign Ovarian Teratomas". New England Journal of Medicine. 292 (2): 63–66. doi:10.1056/NEJM197501092920202. ISSN 0028-4793.
- ↑ Dalmau, Josep; Gleichman, Amy J; Hughes, Ethan G; Rossi, Jeffrey E; Peng, Xiaoyu; Lai, Meizan; Dessain, Scott K; Rosenfeld, Myrna R; Balice-Gordon, Rita; Lynch, David R (2008). "Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies". The Lancet Neurology. 7 (12): 1091–1098. doi:10.1016/S1474-4422(08)70224-2. ISSN 1474-4422.
- ↑ 5.0 5.1 Dysgerminoma. https://en.wikipedia.org/wiki/Dysgerminoma. URL Accessed on November 12, 2015
- ↑ Ovary tumor Germ cell tumors Yolk sac tumor. http://www.pathologyoutlines.com/topic/ovarytumoryolksac.html. URL Accessed on November 12, 2015
- ↑ 7.0 7.1 Abbas, Fausto, Mitchell (2010). Basic Pathology. Elsevier. pp. 696–697. ISBN 978-81-312-1036-9.
- ↑ Yayla Abide, Çiğdem; Bostancı Ergen, Evrim (2018). "Retrospective analysis of mature cystic teratomas in a single center and review of the literature". Journal of Turkish Society of Obstetric and Gynecology. 15 (2): 95–98. doi:10.4274/tjod.86244. ISSN 1307-699X.
- ↑ Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). "Ovarian Teratomas: Tumor Types and Imaging Characteristics". RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.
- ↑ Endodermal sinus tumor. https://en.wikipedia.org/wiki/Endodermal_sinus_tumor. URL Accessed on November 12, 2015
- ↑ Mature teratoma. http://librepathology.org/wiki/index.php/Teratoma#Mature_teratoma. URL Accessed on November 12, 2015
- ↑ Immature teratoma. http://librepathology.org/wiki/index.php/Teratoma#Mature_teratoma. URL Accessed on November 12, 2015
- ↑ Ulbright TM (February 2005). "Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues". Mod. Pathol. 18 Suppl 2: S61–79. doi:10.1038/modpathol.3800310. PMID 15761467.
- ↑ Kallenberg, GA; Pesce, CM; Norman, B; Ratner, RE; Silverberg, SG (1991). "Ectopic hyperprolactinemia resulting from an ovarian teratoma". International Journal of Gynecology & Obstetrics. 34 (2): 194–195. doi:10.1016/0020-7292(91)90266-8. ISSN 0020-7292.