Ovarian Germ Cell Tumors

Question 1

2 big picture ideas to remember about germ cell tumors in ovaries?

Answer 1

1. 2nd most common ovarian tumor

2. Usually occur in women of reproductive age.

Question 2

What are the 5 germ cell tumors?

Answer 2

Cystic teratoma
Embryonal carcinoma
Dysgerminoma
Endodermal sinus tumor
Choriocarcinoma

Question 3

How do we characterize a cystic teratoma and what are they most common of?

Answer 3

Cystic tumor composed of fetal tissue from 2 or three embryo layers.
Most common germ cell tumor in females

Question 4

How can cystic teratomas present and are they malignant or benign?

Answer 4

Bilaterally.

Benign

Question 5

What do we need to do to confirm that a teratoma is benign?

Answer 5

Make sure there is zero immature tissue because if there is, it is an immature teratoma and can become malignant because it hasn’t matured yet.
Need to make sure that there isn’t any malignant tissue.

Question 6

What is the most common immature tissue that is found in an immature teratoma? What is the most common malignant tissue found in a teratoma?

Answer 6

Neural ectoderm

Squamous cell carcinoma of the skin.

Question 7

What are benign teratomas often referred to and why?

Answer 7

Desmond cysts because they almost always have skin

Question 8

Got a female patient who is 20 years old, hyperthryodiism and a mass on her ovary, what are we thinking and why?

Answer 8

Struma ovarri. Cystic Teratoma completely comprised of thyroid tissue.

Question 9

Basically, what is a dysgerminoma?

Answer 9

Mass of a bunch of oocytes or eggs.

Question 10

Dysgerminoma is the most common what?

Answer 10

Malignant germ cell tumor

Question 11

It’s testicular counterpart is what?

Answer 11

Seminoma

Question 12

What is the prognosis and why? Also, what serum marker is elevated with a dysgerminoma?

Answer 12

Good because it responds well to radiotherapy.

LDH

Question 13

3 high yield features of a endodermal sinus tumor?

Answer 13

Most common germ cell tumor in kids
AFP is elevated (mimics yolk sac)
Schiller Duvall bodies (glomerular like structures) on histo

Question 14

What are the two cells in a choriocarcinoma? What is absent that is usually in the placenta?

Answer 14

Trophoblastic and syncytiotrophoblasts

Villi are absent

Question 15

What is gross examination of a choriocarcinoma?

Answer 15

Small, hemorrhagic tumor with early spread via blood.

Question 16

What marker do these tumors secrete?

Answer 16

Beta hCG

Question 17

What is a very high yield feature of choriocarcinoma to know about treatment?

Answer 17

Very poor response to chemo