Ovarian germ cell tumor diagnostic study of choice: Difference between revisions
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** The patient presents with an adnexal mass in the abdominal/pelvic exam, and elevated serum concentration of hCG, LDH, AFP, and other associated tumor markers. | ** The patient presents with an adnexal mass in the abdominal/pelvic exam, and elevated serum concentration of hCG, LDH, AFP, and other associated tumor markers. | ||
** Mature teratoma may be diagnosed using ultrasonographic imaging. However, the tumor should be removed surgically. | ** Mature teratoma may be diagnosed using ultrasonographic imaging. However, the tumor should be removed surgically. | ||
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Revision as of 19:34, 13 March 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Histology of the excised tumor after surgery is the gold standard test for the diagnosis of ovarian germ cell tumors. Surgery must be performed when the patient presents with an adnexal mass in the abdominal/pelvic exam and elevated serum concentration of associated tumor markers. Mature teratoma may be diagnosed using ultrasonographic imaging. However, the tumor should be removed surgically.
Diagnostic Study of Choice
Histology of the excised tumor after surgery is the gold standard test for the diagnosis of ovarian germ cell tumors.[1][2]
- Surgery must be performed when:
- The patient presents with an adnexal mass in the abdominal/pelvic exam, and elevated serum concentration of hCG, LDH, AFP, and other associated tumor markers.
- Mature teratoma may be diagnosed using ultrasonographic imaging. However, the tumor should be removed surgically.
| Malignant germ cell tumor | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Prior surgery | Initial surgery | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Complete staging | Incomplete staging | Fertility sparing prefered | Fertility sparing not prefered | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Treatment based on the staging | Imaging: Chest/ abdomen/ pelvis CT with contrast | Fertility sparing surgery and complete staging | Surgery to stage | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Treatment based on the staging and pathology of tumor | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Yolk sac tumor grade2-3 immature teratoma, non-gestational choriocarcinoma or mixed histology | Dysgerminoma or grade 1 immature teratoma | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Imaging and tumor markers are positive | Negative imaging and positive tumor markers | Negative imaging and negative or positive tumor markers | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Decide according to fertility sparing preference and/or pathologic finding for surgery and further adjuant therapy | Observe | Observe | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Imaging and tumor markers are positive | Negative imaging and negative and positive tumor markers | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Decide according to fertility sparing preference for surgery and further chemotherapy | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Name of Diagnostic Criteria
It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
OR
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
OR
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
- Criteria 1
- Criteria 2
- Criteria 3
OR
IF there are clear, established diagnostic criteria
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
IF there are no established diagnostic criteria
There are no established criteria for the diagnosis of [disease name].
References
- ↑ 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.
- ↑ 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.