Pathology - Ovarian Germ Cell Tumors
Risk factors comprise nulliparity, positive family history of ovarian cancer, mutations in BRCA I and BRCA2 genes, and high expression of the HER2/neu oncogene. Most frequently happens in children and young adults, with the exception of teratomas, which can develop at any age. Dysgerminoma is a malignant tumor seen unilaterally, consisting of large vesicular cells with transparent cytoplasm and central nuclei, similar to male testicular seminoma. Yolk sac tumor is a malignant tumor characterized by Schiller-Duval bodies, which are glomerulus-like structures consisting of a central blood artery surrounded by germ cells. Choriocarcinoma is a highly aggressive and malignant tumor characterized by regions of cell death and bleeding, consisting of cancerous syncytiotrophoblasts and cytotrophoblasts. Teratomas account for 90% of germ cell tumors. Mature teratomas, also known as dermoid cysts, are benign, but immature teratomas are malignant. Histology involves examining structures derived from all germ layers. Struma ovarii is a type of ovarian teratoma that consists of thyroid tissue and often affects only one ovary. Subtle, vague stomach discomfort; struma ovarii can cause hyperthyroidism. Laboratory results: Elevated AFP indicates yolk sac tumor, while high hCG levels suggest choriocarcinoma. Therapy Excision of tumor; surgical removal of ovaries or uterus; chemotherapy. 25% of ovarian cancers are germ cell tumors.
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