Ovarian germ cell tumor pathophysiology: Difference between revisions

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*In 40% of cases, they are accompanied by other types of [[germ cell]] [[tumors]].<ref name="KojimaharaNakahara2013">{{cite journal|last1=Kojimahara|first1=Takanobu|last2=Nakahara|first2=Kenji|last3=Takano|first3=Tadao|last4=Yaegashi|first4=Nobuo|last5=Nishiyama|first5=Hiroshi|last6=Fujimori|first6=Keiya|last7=Sato|first7=Naoki|last8=Terada|first8=Yukihiro|last9=Tase|first9=Toru|last10=Yokoyama|first10=Yoshihito|last11=Mizunuma|first11=Hideki|last12=Shoji|first12=Tadahiro|last13=Sugiyama|first13=Toru|last14=Kurachi|first14=Hirohisa|title=Yolk Sac Tumor of the Ovary: A Retrospective Multicenter Study of 33 Japanese Women by Tohoku Gynecologic Cancer Unit (TGCU)|journal=The Tohoku Journal of Experimental Medicine|volume=230|issue=4|year=2013|pages=211–217|issn=1349-3329|doi=10.1620/tjem.230.211}}</ref>
*In 40% of cases, they are accompanied by other types of [[germ cell]] [[tumors]].<ref name="KojimaharaNakahara2013">{{cite journal|last1=Kojimahara|first1=Takanobu|last2=Nakahara|first2=Kenji|last3=Takano|first3=Tadao|last4=Yaegashi|first4=Nobuo|last5=Nishiyama|first5=Hiroshi|last6=Fujimori|first6=Keiya|last7=Sato|first7=Naoki|last8=Terada|first8=Yukihiro|last9=Tase|first9=Toru|last10=Yokoyama|first10=Yoshihito|last11=Mizunuma|first11=Hideki|last12=Shoji|first12=Tadahiro|last13=Sugiyama|first13=Toru|last14=Kurachi|first14=Hirohisa|title=Yolk Sac Tumor of the Ovary: A Retrospective Multicenter Study of 33 Japanese Women by Tohoku Gynecologic Cancer Unit (TGCU)|journal=The Tohoku Journal of Experimental Medicine|volume=230|issue=4|year=2013|pages=211–217|issn=1349-3329|doi=10.1620/tjem.230.211}}</ref>
==Genetics==
==Genetics==
*Ovarian germ cell teratomas may be associated with cytogenetic abnormalities.
*[[Ovarian]] [[germ cell]] teratomas may be associated with [[cytogenetic]] abnormalities.
*Immature teratomas may be associated with [[chromosomal]] changes such as:<ref name="pmid10850452">{{cite journal |vauthors=Kraggerud SM, Szymanska J, Abeler VM, Kaern J, Eknaes M, Heim S, Teixeira MR, Tropé CG, Peltomäki P, Lothe RA |title=DNA copy number changes in malignant ovarian germ cell tumors |journal=Cancer Res. |volume=60 |issue=11 |pages=3025–30 |date=June 2000 |pmid=10850452 |doi= |url=}}</ref>
*Immature teratomas may be associated with [[chromosomal]] changes such as:<ref name="pmid10850452">{{cite journal |vauthors=Kraggerud SM, Szymanska J, Abeler VM, Kaern J, Eknaes M, Heim S, Teixeira MR, Tropé CG, Peltomäki P, Lothe RA |title=DNA copy number changes in malignant ovarian germ cell tumors |journal=Cancer Res. |volume=60 |issue=11 |pages=3025–30 |date=June 2000 |pmid=10850452 |doi= |url=}}</ref>
**[[Gain]] of all or parts of  
**[[Gain]] of all or parts of  
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***Whole of [[chromosome 19]]
***Whole of [[chromosome 19]]
**Losses from 13q
**Losses from 13q
*Yolk sac tumor is associated with gaining of the 12p [[chromosome]] in 75% of the cases.<ref name="pmid10850452">{{cite journal |vauthors=Kraggerud SM, Szymanska J, Abeler VM, Kaern J, Eknaes M, Heim S, Teixeira MR, Tropé CG, Peltomäki P, Lothe RA |title=DNA copy number changes in malignant ovarian germ cell tumors |journal=Cancer Res. |volume=60 |issue=11 |pages=3025–30 |date=June 2000 |pmid=10850452 |doi= |url=}}</ref>
*Yolk sac [[tumor]] is associated with gaining of the 12p [[chromosome]] in 75% of the cases.<ref name="pmid10850452">{{cite journal |vauthors=Kraggerud SM, Szymanska J, Abeler VM, Kaern J, Eknaes M, Heim S, Teixeira MR, Tropé CG, Peltomäki P, Lothe RA |title=DNA copy number changes in malignant ovarian germ cell tumors |journal=Cancer Res. |volume=60 |issue=11 |pages=3025–30 |date=June 2000 |pmid=10850452 |doi= |url=}}</ref>
**It may also be associated with chromosomal changes such as:
**It may also be associated with [[chromosomal]] changes such as:
***Gain of 1q
***Gain of 1q


==Associated Conditions==
==Associated Conditions==
Conditions associated with mature teratoma include:
Conditions associated with mature teratoma include:
*Anti-NMDA receptor encephalitis (although very rarely)<ref name="DalmauGleichman2008">{{cite journal|last1=Dalmau|first1=Josep|last2=Gleichman|first2=Amy J|last3=Hughes|first3=Ethan G|last4=Rossi|first4=Jeffrey E|last5=Peng|first5=Xiaoyu|last6=Lai|first6=Meizan|last7=Dessain|first7=Scott K|last8=Rosenfeld|first8=Myrna R|last9=Balice-Gordon|first9=Rita|last10=Lynch|first10=David R|title=Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies|journal=The Lancet Neurology|volume=7|issue=12|year=2008|pages=1091–1098|issn=14744422|doi=10.1016/S1474-4422(08)70224-2}}</ref>
*Anti-NMDA receptor [[encephalitis]] (although very rarely)<ref name="DalmauGleichman2008">{{cite journal|last1=Dalmau|first1=Josep|last2=Gleichman|first2=Amy J|last3=Hughes|first3=Ethan G|last4=Rossi|first4=Jeffrey E|last5=Peng|first5=Xiaoyu|last6=Lai|first6=Meizan|last7=Dessain|first7=Scott K|last8=Rosenfeld|first8=Myrna R|last9=Balice-Gordon|first9=Rita|last10=Lynch|first10=David R|title=Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies|journal=The Lancet Neurology|volume=7|issue=12|year=2008|pages=1091–1098|issn=14744422|doi=10.1016/S1474-4422(08)70224-2}}</ref>
*Rarely, they contain pituitary cells capable of prolactin production and is associated with prolactinoma.<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 contain [[pituitary]] [[cells]] capable of [[prolactin]] production and is associated with [[prolactinoma]].<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>


==Gross Pathology==
==Gross Pathology==
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|-
|-
| '''Dysgerminonma'''||
| '''Dysgerminonma'''||
* Unilateral (bilateral in 10% to 20% of the cases)<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>
* Unilateral ([[bilateral]] in 10% to 20% of the cases)<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>
* more common in the right side
* more common on the right side
* Solid, withe od grayish-withe tumors
* [[Solid]], white or grayish-withe [[Tumor|tumors]]
|-
|-
| '''Embryonal Carcinoma'''||
| '''Embryonal Carcinoma'''||
* Unilateral, large mass, averaging 17 cm <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>
* Unilateral, large [[mass]], averaging 17 cm <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>
* Smooth outer surface
* Smooth outer surface
* Extensive area of necrosis and hemorrhage
* Extensive area of [[necrosis]] and [[hemorrhage]]
|-
|-
|'''Endodermal sinus tumor or yolk sac tumors'''||
|'''Endodermal sinus tumor or yolk sac tumors'''||
* Mixed solid and cystic component<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>
* Mixed [[solid]] and [[cystic]] component<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>
* The solid portion is soft with grey to yellow color and areas of necrosis and/or hemorrhage
* The [[solid]] portion is soft with grey to yellow color and areas of [[necrosis]] and/or [[hemorrhage]]
* The cystic portion is in between solid components and result in a meshlike/honeycomb appearance
* The [[cystic]] portion is in between [[solid]] components and results in a meshlike/honeycomb [[appearance]]
* Unilateral and commonly affects the right ovary<ref name="KojimaharaNakahara2013">{{cite journal|last1=Kojimahara|first1=Takanobu|last2=Nakahara|first2=Kenji|last3=Takano|first3=Tadao|last4=Yaegashi|first4=Nobuo|last5=Nishiyama|first5=Hiroshi|last6=Fujimori|first6=Keiya|last7=Sato|first7=Naoki|last8=Terada|first8=Yukihiro|last9=Tase|first9=Toru|last10=Yokoyama|first10=Yoshihito|last11=Mizunuma|first11=Hideki|last12=Shoji|first12=Tadahiro|last13=Sugiyama|first13=Toru|last14=Kurachi|first14=Hirohisa|title=Yolk Sac Tumor of the Ovary: A Retrospective Multicenter Study of 33 Japanese Women by Tohoku Gynecologic Cancer Unit (TGCU)|journal=The Tohoku Journal of Experimental Medicine|volume=230|issue=4|year=2013|pages=211–217|issn=1349-3329|doi=10.1620/tjem.230.211}}</ref>
* Unilateral and commonly affects the right [[ovary]]<ref name="KojimaharaNakahara2013">{{cite journal|last1=Kojimahara|first1=Takanobu|last2=Nakahara|first2=Kenji|last3=Takano|first3=Tadao|last4=Yaegashi|first4=Nobuo|last5=Nishiyama|first5=Hiroshi|last6=Fujimori|first6=Keiya|last7=Sato|first7=Naoki|last8=Terada|first8=Yukihiro|last9=Tase|first9=Toru|last10=Yokoyama|first10=Yoshihito|last11=Mizunuma|first11=Hideki|last12=Shoji|first12=Tadahiro|last13=Sugiyama|first13=Toru|last14=Kurachi|first14=Hirohisa|title=Yolk Sac Tumor of the Ovary: A Retrospective Multicenter Study of 33 Japanese Women by Tohoku Gynecologic Cancer Unit (TGCU)|journal=The Tohoku Journal of Experimental Medicine|volume=230|issue=4|year=2013|pages=211–217|issn=1349-3329|doi=10.1620/tjem.230.211}}</ref>
|-
|-
| '''Mixed germ cell tumors'''||
| '''Mixed germ cell tumors'''||
* Composed of more than one germ cell tumor element<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>
* Composed of more than one [[germ cell]] [[tumor]] element<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>
* Main components are:
* Main components are:
** Dysgerminoma
** Dysgerminoma
** Teratoma
** Teratoma
** Yolk sac tumor
** Yolk sac [[tumor]]
* Other germ cell tumors may be present
* Other [[germ cell]] [[tumors]] may be present
|-
|-
| '''Polyembryoma'''||
| '''Polyembryoma'''||
* Large, unilateral tumor with microcystic surface<ref name="OlivaYoung2014">{{cite journal|last1=Oliva|first1=Esther|last2=Young|first2=Robert H.|title=Germ cell tumours of the ovary: selected topics|journal=Diagnostic Histopathology|volume=20|issue=9|year=2014|pages=364–375|issn=17562317|doi=10.1016/j.mpdhp.2014.07.003}}</ref>
* Large, unilateral [[tumor]] with microcystic surface<ref name="OlivaYoung2014">{{cite journal|last1=Oliva|first1=Esther|last2=Young|first2=Robert H.|title=Germ cell tumours of the ovary: selected topics|journal=Diagnostic Histopathology|volume=20|issue=9|year=2014|pages=364–375|issn=17562317|doi=10.1016/j.mpdhp.2014.07.003}}</ref>
* Bulky appearance
* Bulky [[appearance]]
* Soft and reddish-brown color
* Soft and reddish-brown color
* hemorrhage in cut surfaces
* [[hemorrhage]] in cut surfaces
|-
|-
| '''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>
* 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>
* Unilocular in the magority of cases (88%)
* Unilocular in the majority of cases (88%)
* Predominantly cystic
* Predominantly [[cystic]]
* Cystic content may contain sebaseous material that is semiliquide in room temperature
* [[Cystic]] content may contain sebaseous material that is [[semi-liquid]] 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>
* 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
* May be [[solid]] or with a prominent [[solid]] element
* Cystic cavities may be filled with serous or mucinous or fatty-sebaceous fluide.
* [[Cystic]] [[cavities]] may be filled with [[serous]] or [[mucinous]] or fatty-[[sebaceous]] fluid.
* Ths capsular component may not always be well-defined
* Ths [[capsular]] component may not always be well-defined
'''Teratoma-monodermal'''
'''Teratoma-monodermal'''
* Struma ovarii: amber-colored thyroid tissue with areas of hemorrhage, necrosis, and fibrosis <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>
* Struma ovarii: amber-colored [[thyroid]] tissue with areas of [[hemorrhage]], [[necrosis]], and [[fibrosis]] <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>
* Carcinoid tumor: a solid mass
* Carcinoid [[tumor]]: a [[solid]] [[mass]]
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|''' Dysgerminomas'''||
|''' Dysgerminomas'''||
* large, uniform, clear cells arranged in sheets <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>
* large, uniform, clear [[cells]] arranged in sheets <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>
* Uniform cells has an "fried egg appearance"(large cytoplasm and small nucleus) that resemble primordial germ cells
* Uniform [[cells]] has an "fried egg [[appearance]]"(large [[cytoplasm]] and small [[nucleus]]) that resemble [[primordial germ cells]]
* The stroma contains lymphocytes and septa like components.
* The [[stroma]] contains [[lymphocytes]] and [[septa]] like components.
| [[File:Dysgerminoma.jpg|thumb|none|400px|Micrograph a seminoma, a tumor that is histologically indistinguishable from dysgerminoma.]]
| [[File:Dysgerminoma.jpg|thumb|none|400px|Micrograph a seminoma, a tumor that is histologically indistinguishable from dysgerminoma.]]


|-
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|''' Embryonal carcinoma'''||
|''' Embryonal carcinoma'''||
* Pseudoglandular pattern of primiticve cells <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>
* Pseudoglandular pattern of [[Primitive (integral)|primitive]] [[cells]] <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>
* Nuclei are:
* [[Nuclei]] are:
** Large
** Large
** Croweded
** Croweded
** Pleomorphic
** Pleomorphic
** With prominent nucleoli
** With prominent [[nucleoli]]
| [[Image:800px-Embryonal_carcinoma_-_high_mag.jpg‎|300px|thumb|none| Embryonal carcinoma]]
| [[Image:800px-Embryonal_carcinoma_-_high_mag.jpg‎|300px|thumb|none| Embryonal carcinoma]]
|-
|-
|'''Endodermal sinus tumor or yolk sac tumors'''||
|'''Endodermal sinus tumor or yolk sac tumors'''||
* Schiller-Duval bodies (resemble renal glomeruli) - key feature <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>
* Schiller-Duval bodies (resemble renal [[glomeruli]]) - key feature <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>
| [[Image:800px-Mixed_germ_cell_tumour_-_high_mag.jpg|thumb|none|300px|Micrograph showing the yolk sac component of a mixed germ cell tumor.]]
| [[Image:800px-Mixed_germ_cell_tumour_-_high_mag.jpg|thumb|none|300px|Micrograph showing the yolk sac component of a mixed germ cell tumor.]]
|-
|-
|'''Polyemryoma'''||
|'''Polyemryoma'''||
* Usually as a part of mixed germ cell tumor<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>
* Usually as a part of mixed [[germ cell]] [[tumor]]<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>
* Contains small ebryo-like bodies with central germ disks
* Contains small [[embryo]]-like bodies with central germ disks
* Germ disk cavity has two part:
* Germ disk [[cavity]] has two part:
** Embryonal carcinoma epithelia
** Embryonal carcinoma [[epithelia]]
** Two cavities:
** Two cavities:
*** Dorsal cavity that resembles the amniotic cavity
*** Dorsal cavity that resembles the amniotic cavity
*** Ventral cavity that resembles the yolk sac cavity
*** Ventral cavity that resembles the [[yolk sac]] cavity
|  
|  
|-
|-
Line 190: Line 190:
===Dysgerminoma===
===Dysgerminoma===
* Dysgerminoma is positive for:<ref name="PectasidesPectasides2008">{{cite journal|last1=Pectasides|first1=D.|last2=Pectasides|first2=E.|last3=Kassanos|first3=D.|title=Germ cell tumors of the ovary|journal=Cancer Treatment Reviews|volume=34|issue=5|year=2008|pages=427–441|issn=03057372|doi=10.1016/j.ctrv.2008.02.002}}</ref>
* Dysgerminoma is positive for:<ref name="PectasidesPectasides2008">{{cite journal|last1=Pectasides|first1=D.|last2=Pectasides|first2=E.|last3=Kassanos|first3=D.|title=Germ cell tumors of the ovary|journal=Cancer Treatment Reviews|volume=34|issue=5|year=2008|pages=427–441|issn=03057372|doi=10.1016/j.ctrv.2008.02.002}}</ref>
** OCT4 (this marker is a key diagnostic factor for the diagnosis of dysgerminoma)
** OCT4 (this [[marker]] is a key [[diagnostic]] factor for the [[diagnosis]] of dysgerminoma)
===Embryonal carcinoma===
===Embryonal carcinoma===
*These tumors are positive for:<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>
*These [[Tumor|tumors]] are positive for:<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>
** CD30
** [[CD30]]
** EMA
** EMA
** OCT3/4
** OCT3/4
===Endodermal sinus tumor===
===Endodermal sinus tumor===
* Yolk sac tumors are positive for:<ref name="PectasidesPectasides2008">{{cite journal|last1=Pectasides|first1=D.|last2=Pectasides|first2=E.|last3=Kassanos|first3=D.|title=Germ cell tumors of the ovary|journal=Cancer Treatment Reviews|volume=34|issue=5|year=2008|pages=427–441|issn=03057372|doi=10.1016/j.ctrv.2008.02.002}}</ref><ref name="CaoGuo2009">{{cite journal|last1=Cao|first1=Dengfeng|last2=Guo|first2=Shuangping|last3=Allan|first3=Robert W.|last4=Molberg|first4=Kyle H.|last5=Peng|first5=Yan|title=SALL4 Is a Novel Sensitive and Specific Marker of Ovarian Primitive Germ Cell Tumors and Is Particularly Useful in Distinguishing Yolk Sac Tumor From Clear Cell Carcinoma|journal=The American Journal of Surgical Pathology|volume=33|issue=6|year=2009|pages=894–904|issn=0147-5185|doi=10.1097/PAS.0b013e318198177d}}</ref>
* Yolk sac [[Tumor|tumors]] are positive for:<ref name="PectasidesPectasides2008">{{cite journal|last1=Pectasides|first1=D.|last2=Pectasides|first2=E.|last3=Kassanos|first3=D.|title=Germ cell tumors of the ovary|journal=Cancer Treatment Reviews|volume=34|issue=5|year=2008|pages=427–441|issn=03057372|doi=10.1016/j.ctrv.2008.02.002}}</ref><ref name="CaoGuo2009">{{cite journal|last1=Cao|first1=Dengfeng|last2=Guo|first2=Shuangping|last3=Allan|first3=Robert W.|last4=Molberg|first4=Kyle H.|last5=Peng|first5=Yan|title=SALL4 Is a Novel Sensitive and Specific Marker of Ovarian Primitive Germ Cell Tumors and Is Particularly Useful in Distinguishing Yolk Sac Tumor From Clear Cell Carcinoma|journal=The American Journal of Surgical Pathology|volume=33|issue=6|year=2009|pages=894–904|issn=0147-5185|doi=10.1097/PAS.0b013e318198177d}}</ref>
** AFP
** [[AFP]]
*** Absence of AFP does not exclude the diagnosis.
*** Absence of AFP does not exclude the [[diagnosis]].
** Cytokeratin (AE1/AE3)
** [[Cytokeratin]] (AE1/AE3)
** Placental-like alkaline phosphatase in 50% of the individuals.
** Placental-like alkaline phosphatase in 50% of the individuals.
** SALL4 (nuclear) in > 90% of the cases.
** SALL4 ([[nuclear]]) in > 90% of the cases.
** GPC3
** GPC3
===Non-gestational chriocarcinoma===
===Non-gestational chriocarcinoma===
*These tumors stain for keratins strongly.<ref name="pmid12548163">{{cite journal |vauthors=Ordi J, Romagosa C, Tavassoli FA, Nogales F, Palacin A, Condom E, Torné A, Cardesa A |title=CD10 expression in epithelial tissues and tumors of the gynecologic tract: a useful marker in the diagnosis of mesonephric, trophoblastic, and clear cell tumors |journal=Am. J. Surg. Pathol. |volume=27 |issue=2 |pages=178–86 |date=February 2003 |pmid=12548163 |doi= |url=}}</ref>
*These [[tumors]] [[stain]] for [[keratins]] strongly.<ref name="pmid12548163">{{cite journal |vauthors=Ordi J, Romagosa C, Tavassoli FA, Nogales F, Palacin A, Condom E, Torné A, Cardesa A |title=CD10 expression in epithelial tissues and tumors of the gynecologic tract: a useful marker in the diagnosis of mesonephric, trophoblastic, and clear cell tumors |journal=Am. J. Surg. Pathol. |volume=27 |issue=2 |pages=178–86 |date=February 2003 |pmid=12548163 |doi= |url=}}</ref>
** AE1
** AE1
** AE3  
** AE3  
Line 211: Line 211:
*Trophoblastic cells are positive for CD10.
*Trophoblastic cells are positive for CD10.
*Tumor may be positive for:
*Tumor may be positive for:
** GATA3 (nuclear) in 80% of the cases<ref name="BanetGown2015">{{cite journal|last1=Banet|first1=Natalie|last2=Gown|first2=Allen M.|last3=Shih|first3=Ie-Ming|last4=Kay Li|first4=Qing|last5=Roden|first5=Richard B.S.|last6=Nucci|first6=Marisa R.|last7=Cheng|first7=Liang|last8=Przybycin|first8=Christopher G.|last9=Nasseri-Nik|first9=Niloofar|last10=Wu|first10=Lee-Shu-Fune|last11=Netto|first11=George J.|last12=Ronnett|first12=Brigitte M.|last13=Vang|first13=Russell|title=GATA-3 Expression in Trophoblastic Tissues|journal=The American Journal of Surgical Pathology|volume=39|issue=1|year=2015|pages=101–108|issn=0147-5185|doi=10.1097/PAS.0000000000000315}}</ref>
** GATA3 ([[nuclear]]) in 80% of the cases<ref name="BanetGown2015">{{cite journal|last1=Banet|first1=Natalie|last2=Gown|first2=Allen M.|last3=Shih|first3=Ie-Ming|last4=Kay Li|first4=Qing|last5=Roden|first5=Richard B.S.|last6=Nucci|first6=Marisa R.|last7=Cheng|first7=Liang|last8=Przybycin|first8=Christopher G.|last9=Nasseri-Nik|first9=Niloofar|last10=Wu|first10=Lee-Shu-Fune|last11=Netto|first11=George J.|last12=Ronnett|first12=Brigitte M.|last13=Vang|first13=Russell|title=GATA-3 Expression in Trophoblastic Tissues|journal=The American Journal of Surgical Pathology|volume=39|issue=1|year=2015|pages=101–108|issn=0147-5185|doi=10.1097/PAS.0000000000000315}}</ref>
** SALL4 (nuclear) in 70% of the cases<ref name="MiettinenWang2014">{{cite journal|last1=Miettinen|first1=Markku|last2=Wang|first2=Zengfeng|last3=McCue|first3=Peter A.|last4=Sarlomo-Rikala|first4=Maarit|last5=Rys|first5=Janusz|last6=Biernat|first6=Wojciech|last7=Lasota|first7=Jerzy|last8=Lee|first8=Yi-Shan|title=SALL4 Expression in Germ Cell and Non–Germ Cell Tumors|journal=The American Journal of Surgical Pathology|volume=38|issue=3|year=2014|pages=410–420|issn=0147-5185|doi=10.1097/PAS.0000000000000116}}</ref>
** SALL4 ([[nuclear]]) in 70% of the cases<ref name="MiettinenWang2014">{{cite journal|last1=Miettinen|first1=Markku|last2=Wang|first2=Zengfeng|last3=McCue|first3=Peter A.|last4=Sarlomo-Rikala|first4=Maarit|last5=Rys|first5=Janusz|last6=Biernat|first6=Wojciech|last7=Lasota|first7=Jerzy|last8=Lee|first8=Yi-Shan|title=SALL4 Expression in Germ Cell and Non–Germ Cell Tumors|journal=The American Journal of Surgical Pathology|volume=38|issue=3|year=2014|pages=410–420|issn=0147-5185|doi=10.1097/PAS.0000000000000116}}</ref>
** PLAP and EMA in 50% of the cases<ref name="pmid2457424">{{cite journal |vauthors=Niehans GA, Manivel JC, Copland GT, Scheithauer BW, Wick MR |title=Immunohistochemistry of germ cell and trophoblastic neoplasms |journal=Cancer |volume=62 |issue=6 |pages=1113–23 |date=September 1988 |pmid=2457424 |doi= |url=}}</ref>
** PLAP and EMA in 50% of the cases<ref name="pmid2457424">{{cite journal |vauthors=Niehans GA, Manivel JC, Copland GT, Scheithauer BW, Wick MR |title=Immunohistochemistry of germ cell and trophoblastic neoplasms |journal=Cancer |volume=62 |issue=6 |pages=1113–23 |date=September 1988 |pmid=2457424 |doi= |url=}}</ref>
===Polyembryoma===
===Polyembryoma===
* Embryoid body of the tumor may be positive for Glypican3.<ref name="PredaNicolae2011">{{cite journal|last1=Preda|first1=Ovidiu|last2=Nicolae|first2=Alina|last3=Aneiros-Fernández|first3=José|last4=Borda|first4=Angela|last5=Nogales|first5=Francisco F|title=Glypican 3 is a sensitive, but not a specific, marker for the diagnosis of yolk sac tumours|journal=Histopathology|volume=58|issue=2|year=2011|pages=312–314|issn=03090167|doi=10.1111/j.1365-2559.2010.03735.x}}</ref>
* Embryoid body of the [[tumor]] may be positive for Glypican3.<ref name="PredaNicolae2011">{{cite journal|last1=Preda|first1=Ovidiu|last2=Nicolae|first2=Alina|last3=Aneiros-Fernández|first3=José|last4=Borda|first4=Angela|last5=Nogales|first5=Francisco F|title=Glypican 3 is a sensitive, but not a specific, marker for the diagnosis of yolk sac tumours|journal=Histopathology|volume=58|issue=2|year=2011|pages=312–314|issn=03090167|doi=10.1111/j.1365-2559.2010.03735.x}}</ref>
===Teratoma===
===Teratoma===
* Usually, teratomas are diagnosed histologically and routine use of immunohistochemistry is not needed. However it may be needed in the diagnosis of immature and monodermal types.
* Usually, teratomas are diagnosed histologically and routine use of [[immunohistochemistry]] is not needed. However it may be needed in the [[diagnosis]] of immature and monodermal types.
* Neuronal elements of mature or immature teratomas are immunohistochemistically positive for:<ref name="TakayamaMatsumura2015">{{cite journal|last1=Takayama|first1=Yoshiyasu|last2=Matsumura|first2=Nozomi|last3=Nobusawa|first3=Sumihito|last4=Ikota|first4=Hayato|last5=Minegishi|first5=Takashi|last6=Yokoo|first6=Hideaki|title=Immunophenotypic features of immaturity of neural elements in ovarian teratoma|journal=Virchows Archiv|volume=468|issue=3|year=2015|pages=337–343|issn=0945-6317|doi=10.1007/s00428-015-1891-8}}</ref>
* [[Neuronal]] elements of mature or immature teratomas are positive for:<ref name="TakayamaMatsumura2015">{{cite journal|last1=Takayama|first1=Yoshiyasu|last2=Matsumura|first2=Nozomi|last3=Nobusawa|first3=Sumihito|last4=Ikota|first4=Hayato|last5=Minegishi|first5=Takashi|last6=Yokoo|first6=Hideaki|title=Immunophenotypic features of immaturity of neural elements in ovarian teratoma|journal=Virchows Archiv|volume=468|issue=3|year=2015|pages=337–343|issn=0945-6317|doi=10.1007/s00428-015-1891-8}}</ref>
** Glial fibrillary acidic protein (GFAP)
** Glial fibrillary acidic protein (GFAP)
** neuron specific enolase (NSE)
** neuron specific enolase (NSE)
** S-100
** S-100
* Monodermal teratoma<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>
* Monodermal teratoma<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>
** Carcionid tumor may be positive for serotonin and hormonal peptides.
** Carcionid [[tumor]] may be positive for [[serotonin]] and [[hormonal]] [[peptides]].


==References==
==References==

Revision as of 21:21, 8 March 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]

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


 
 
 
 
 
 
 
Germ cell
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pathogenesis
 
 
 
 
 
 
 
Malignant transformation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mature teratoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Tumors esxpressing transcription factors of pluripotency
 
Tumors with primitive embryonic ectoderm, mesoderm, and/or endoderm differentiation
 
Tumors with extraembroyonic differentiation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Dysgerminoma/Embryonal carcinoma
 
Immature teratoma
 
Yolk sac tumor/Choriocarcinoma
 

Mature teratoma

Dysgerminoma

Yolk sac tumor

Genetics

Associated Conditions

Conditions associated with mature teratoma include:

Gross Pathology

Ovarian germ cell tumor subtype Features on Gross Pathology
Dysgerminonma
  • Unilateral (bilateral in 10% to 20% of the cases)[13]
  • more common on the right side
  • Solid, white or grayish-withe tumors
Embryonal Carcinoma
Endodermal sinus tumor or yolk sac tumors
Mixed germ cell tumors
Polyembryoma
Teratoma

Teratoma-mature

  • The majority are 5 to 10 cm in diameter.[15]
  • Unilocular in the majority of cases (88%)
  • Predominantly cystic
  • Cystic content may contain sebaseous material that is semi-liquid in room temperature
  • Teeth may be found in Rokitansky’s protuberance - a well-defined, nipple-like structure covered with hair

Teratoma-immature

Teratoma-monodermal

Microscopic Pathology

Ovarian germ cell tumor subtype Features on Histopathological Microscopic Analysis Image
Dysgerminomas
Micrograph a seminoma, a tumor that is histologically indistinguishable from dysgerminoma.
Embryonal carcinoma
Embryonal carcinoma
Endodermal sinus tumor or yolk sac tumors
  • Schiller-Duval bodies (resemble renal glomeruli) - key feature [8]
Micrograph showing the yolk sac component of a mixed germ cell tumor.
Polyemryoma
  • Usually as a part of mixed germ cell tumor[8]
  • Contains small embryo-like bodies with central germ disks
  • Germ disk cavity has two part:
    • Embryonal carcinoma epithelia
    • Two cavities:
      • Dorsal cavity that resembles the amniotic cavity
      • Ventral cavity that resembles the yolk sac cavity
Teratoma

Mature teratoma

  • The sections show ovarian parenchyma with a lesion consisting of benign dermal, gastrointestinal, and neural elements.[17]
  • The neural elements show focal degenerative changes with macrophages and giant cells
  • Siderophages are present.
  • In general, mature teratoma usually appears as a well-established organization of tissues mimicking the relationship observed in normal organs such as:[18]
    • 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.[12]
      • Rarely, they produce prolactin and is associated with prolactinoma.

Immature teratoma

  • Tissues originating from the two or three embroyanl layers are present.[8]
  • There is a mixture of mature and immature tissue (primitive cells).
  • The presence of primitive elements is necessary to make the diagnosis.
Teratoma

Immunohistochemistry

Dysgerminoma

Embryonal carcinoma

Endodermal sinus tumor

  • Yolk sac tumors are positive for:[19][20]
    • AFP
      • Absence of AFP does not exclude the diagnosis.
    • Cytokeratin (AE1/AE3)
    • Placental-like alkaline phosphatase in 50% of the individuals.
    • SALL4 (nuclear) in > 90% of the cases.
    • GPC3

Non-gestational chriocarcinoma

  • These tumors stain for keratins strongly.[21]
    • AE1
    • AE3
    • CAM5
  • Trophoblastic cells are positive for CD10.
  • Tumor may be positive for:

Polyembryoma

  • Embryoid body of the tumor may be positive for Glypican3.[25]

Teratoma

  • Usually, teratomas are diagnosed histologically and routine use of immunohistochemistry is not needed. However it may be needed in the diagnosis of immature and monodermal types.
  • Neuronal elements of mature or immature teratomas are positive for:[26]
    • Glial fibrillary acidic protein (GFAP)
    • neuron specific enolase (NSE)
    • S-100
  • Monodermal teratoma[16]

References

  1. ↑ 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. ↑ Carcangiu, M. L. (2014). WHO Classification of Tumours of Female Reproductive Organs. Lyon: International Agency for Research on Cancer. ISBN 978-92-832-4487-5.
  3. ↑ 3.0 3.1 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.
  4. ↑ 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.
  5. ↑ 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 (December 2012). "Pure dysgerminoma of the ovary: a single institutional experience of 65 patients". Med. Oncol. 29 (4): 2944–8. doi:10.1007/s12032-012-0194-z. PMID 22407668. Vancouver style error: missing comma (help)
  6. ↑ Gordon A, Lipton D, Woodruff JD (October 1981). "Dysgerminoma: a review of 158 cases from the Emil Novak Ovarian Tumor Registry". Obstet Gynecol. 58 (4): 497–504. PMID 7279343.
  7. ↑ Young, Robert H. (2014). "The Yolk Sac Tumor". International Journal of Surgical Pathology. 22 (8): 677–687. doi:10.1177/1066896914558265. ISSN 1066-8969.
  8. ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 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.
  9. ↑ 9.0 9.1 Kojimahara, Takanobu; Nakahara, Kenji; Takano, Tadao; Yaegashi, Nobuo; Nishiyama, Hiroshi; Fujimori, Keiya; Sato, Naoki; Terada, Yukihiro; Tase, Toru; Yokoyama, Yoshihito; Mizunuma, Hideki; Shoji, Tadahiro; Sugiyama, Toru; Kurachi, Hirohisa (2013). "Yolk Sac Tumor of the Ovary: A Retrospective Multicenter Study of 33 Japanese Women by Tohoku Gynecologic Cancer Unit (TGCU)". The Tohoku Journal of Experimental Medicine. 230 (4): 211–217. doi:10.1620/tjem.230.211. ISSN 1349-3329.
  10. ↑ 10.0 10.1 10.2 Kraggerud SM, Szymanska J, Abeler VM, Kaern J, Eknaes M, Heim S, Teixeira MR, Tropé CG, Peltomäki P, Lothe RA (June 2000). "DNA copy number changes in malignant ovarian germ cell tumors". Cancer Res. 60 (11): 3025–30. PMID 10850452.
  11. ↑ 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.
  12. ↑ 12.0 12.1 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.
  13. ↑ Chen, Vivien W.; Ruiz, Bernardo; Killeen, Jeffrey L.; Cot�, Timothy R.; Wu, Xiao Cheng; Correa, Catherine N.; Howe, Holly L. (2003). "Pathology and classification of ovarian tumors". Cancer. 97 (S10): 2631–2642. doi:10.1002/cncr.11345. ISSN 0008-543X. replacement character in |last4= at position 4 (help)
  14. ↑ Oliva, Esther; Young, Robert H. (2014). "Germ cell tumours of the ovary: selected topics". Diagnostic Histopathology. 20 (9): 364–375. doi:10.1016/j.mpdhp.2014.07.003. ISSN 1756-2317.
  15. ↑ 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.
  16. ↑ 16.0 16.1 16.2 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.
  17. ↑ Mature teratoma. http://librepathology.org/wiki/index.php/Teratoma#Mature_teratoma. URL Accessed on November 12, 2015
  18. ↑ 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.
  19. ↑ 19.0 19.1 Pectasides, D.; Pectasides, E.; Kassanos, D. (2008). "Germ cell tumors of the ovary". Cancer Treatment Reviews. 34 (5): 427–441. doi:10.1016/j.ctrv.2008.02.002. ISSN 0305-7372.
  20. ↑ Cao, Dengfeng; Guo, Shuangping; Allan, Robert W.; Molberg, Kyle H.; Peng, Yan (2009). "SALL4 Is a Novel Sensitive and Specific Marker of Ovarian Primitive Germ Cell Tumors and Is Particularly Useful in Distinguishing Yolk Sac Tumor From Clear Cell Carcinoma". The American Journal of Surgical Pathology. 33 (6): 894–904. doi:10.1097/PAS.0b013e318198177d. ISSN 0147-5185.
  21. ↑ Ordi J, Romagosa C, Tavassoli FA, Nogales F, Palacin A, Condom E, Torné A, Cardesa A (February 2003). "CD10 expression in epithelial tissues and tumors of the gynecologic tract: a useful marker in the diagnosis of mesonephric, trophoblastic, and clear cell tumors". Am. J. Surg. Pathol. 27 (2): 178–86. PMID 12548163.
  22. ↑ Banet, Natalie; Gown, Allen M.; Shih, Ie-Ming; Kay Li, Qing; Roden, Richard B.S.; Nucci, Marisa R.; Cheng, Liang; Przybycin, Christopher G.; Nasseri-Nik, Niloofar; Wu, Lee-Shu-Fune; Netto, George J.; Ronnett, Brigitte M.; Vang, Russell (2015). "GATA-3 Expression in Trophoblastic Tissues". The American Journal of Surgical Pathology. 39 (1): 101–108. doi:10.1097/PAS.0000000000000315. ISSN 0147-5185.
  23. ↑ Miettinen, Markku; Wang, Zengfeng; McCue, Peter A.; Sarlomo-Rikala, Maarit; Rys, Janusz; Biernat, Wojciech; Lasota, Jerzy; Lee, Yi-Shan (2014). "SALL4 Expression in Germ Cell and Non–Germ Cell Tumors". The American Journal of Surgical Pathology. 38 (3): 410–420. doi:10.1097/PAS.0000000000000116. ISSN 0147-5185.
  24. ↑ Niehans GA, Manivel JC, Copland GT, Scheithauer BW, Wick MR (September 1988). "Immunohistochemistry of germ cell and trophoblastic neoplasms". Cancer. 62 (6): 1113–23. PMID 2457424.
  25. ↑ Preda, Ovidiu; Nicolae, Alina; Aneiros-Fernández, José; Borda, Angela; Nogales, Francisco F (2011). "Glypican 3 is a sensitive, but not a specific, marker for the diagnosis of yolk sac tumours". Histopathology. 58 (2): 312–314. doi:10.1111/j.1365-2559.2010.03735.x. ISSN 0309-0167.
  26. ↑ Takayama, Yoshiyasu; Matsumura, Nozomi; Nobusawa, Sumihito; Ikota, Hayato; Minegishi, Takashi; Yokoo, Hideaki (2015). "Immunophenotypic features of immaturity of neural elements in ovarian teratoma". Virchows Archiv. 468 (3): 337–343. doi:10.1007/s00428-015-1891-8. ISSN 0945-6317.

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