Epithelial ovarian tumors diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hannan Javed, M.D.[2]
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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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.