Ovarian germ cell tumor natural history

Jump to navigation Jump to search

Ovarian germ cell tumor Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Ovarian germ cell tumor from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Staging

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Surgery

Chemotherapy

Radiotherapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Ovarian germ cell tumor natural history On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ovarian germ cell tumor natural history

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Ovarian germ cell tumor natural history

CDC on Ovarian germ cell tumor natural history

Ovarian germ cell tumor natural history in the news

Blogs on Ovarian germ cell tumor natural history

Directions to Hospitals Treating Ovarian germ cell tumor

Risk calculators and risk factors for Ovarian germ cell tumor natural history

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

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. 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

  • The symptoms of ovarian germ cell tumors usually develop in the teenage years with abdominal pain or fullness, and palpable pelvic/abdominal mass.[1]

Dysgerminomas

  • These tumors tend to spread late and do so through lymphatic system primarily.[2]

Yolk sac tumor

  • These tumors tend to grow rapidly and spread to abdominopelvic cavity in early stages.[3]
  • They are mostly affects women in theie second or third decade of life.[4]

Embryonal carcinoma

  • These tumors tend to metastasize early.[5]
  • They spread through the lymphatic system.

Choriocarcinoma

  • These tumors are highly malignant and tend to spread locally and within the abdominal cavity.[5]
  • They spread early in the course of the tumor.
  • Non-gestational choriocarcinomas spread through lymphatic system.
  • Gestational choriocarcinomas spread through Bloodstream.

Complications

Mature teratoma

Common complications of mature teratoma include:[6]

  • Ovarian torsion is the most common complication and affects 5% to 10% of the individuals.
    • It happens at a greater extent in:[7]
      • Younger age (10-19 years)
      • Larger tumors
  • Rupture in < 4% of the affected individuals.[6]
    • Rupture may be associated with leakage of sebaceous contents of the tumor into the peritoneal cavity and leads to granulomatous peritonitis.[8]
      • This complication is very rere 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.[9]
    • The tumor undergoes malignant transformation to squamous cell carcinma in 80% of them and to adenocarcinoma in the rest of the cases.

Dysgerminoma

  • Ovarian torsion and acute abdominal pain may occur in < 10% of the cases.[10]

Prognosis

  • Only 3% to 5% of ovarian germ cell tumors are malignant which the majority include:[11]
    • Dysgerminomas
    • Immature teratomas
    • Yolk sac tumors
      • Pure form
      • Part of a mixed germ cell tumor

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]%.[12]

Immature teratoma

The prognosis of immature teratoma is favorable.[13]

  • The overall 5-year survival rate is 90%.
  • The 5-yr survival for stages III and IV is 75%.
  • Relapse rate is 20% for grade III 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.[14]
  • The 5-year survival rate of the patient even with disseminated disease at the time of diagnosis is above 90%.
  • Reoccurence 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.

Yolk sac tumor

  • These tumors are highly malignant and tend to spread early.[5]
  • The survival rate depends on the stage of the tumor:
    • For Stage I–II is 60–100%
    • For Stage III–IV disease is 50–75% after appropriate chemotherapy.
  • The overall 5-year survival rate is 80%.[15]
  • Relapse rate is 20% overall.

Embryonal carcinoma

  • These tumors tend to metastasize early.[5]
  • The survival rate is simmilar to yolk sac tumor.

Choriocarcinoma

  • These tumors are highly malignant and tend to spread locally and within the abdominal cavity.[5]
  • They spread early in the course of the tumor.
  • Survival rate is improved with combination chemotheraspy.
  • The majority of patients do not experience the reocurrence except those with non-gestational choriocarcinoma.
  • The overall 5-year survival rate is 80%.[16]
  • Relapse rate is 20% overall.

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. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 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)
  6. ↑ 6.0 6.1 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.
  7. ↑ 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.
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ 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)
  11. ↑ 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.
  12. ↑ 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.
  13. ↑ . doi:10.1016/B978-0-323-44732-4.00026-1. Missing or empty |title= (help)
  14. ↑ 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.
  15. ↑ . doi:10.1016/B978-0-323-44732-4.00026-1. Missing or empty |title= (help)
  16. ↑ . doi:10.1016/B978-0-323-44732-4.00026-1. Missing or empty |title= (help)
Retrieved from "https://www.wikidoc.org/index.php?title=Ovarian_germ_cell_tumor_natural_history&oldid=1556159"