Ovarian germ cell tumors

Content sourced from Wikipedia, licensed under CC BY-SA 3.0.

Ovarian germ cell tumors (OGCTs) are rare cancers that come from the germ cells in the ovary. They make up less than 3% of ovarian cancers and usually affect teenagers and young women.

Types
- Dysgerminoma (about 32–37% of OGCTs): a malignant germ cell tumor of the ovary.
- Teratoma: can be mature (benign) or immature (malignant). Immature teratomas often occur in teens.
- Yolk sac tumor (endodermal sinus tumor): about 15% of OGCTs; grows quickly.
- Choriocarcinoma: rare (about 2–3%).

Symptoms
- Abdominal bloating or swelling, a noticeable mass, and sometimes ascites (fluid in the abdomen).
- Pain during sex (dyspareunia) or abdominal pain if the tumor ruptures.
- In children, may cause early puberty in some cases.
- OGCTs can be hard to detect early because symptoms are nonspecific.

Causes and risk
- The exact cause isn’t fully known. Genetic factors may play a role.
- Some conditions (like endometriosis and polycystic ovary syndrome) may affect risk.
- Pregnancy and oral contraceptives may reduce risk.

Diagnosis and staging
- Diagnosed with pelvic exam, imaging (ultrasound or CT), and blood tests for tumor markers (hCG and AFP; other markers like LDH, ALP, or CA-125 may also help).
- Stages (FIGO):
- Stage I: confined to ovaries or fallopian tubes.
- Stage II: in one or both ovaries/tubes and the pelvis.
- Stage III: spread outside the pelvis to the abdomen or to abdominal lymph nodes.
- Stage IV: distant metastasis (e.g., to the lungs).

Treatment
- Surgery first, aiming to preserve fertility if possible (unilateral salpingo-oophorectomy, removing one ovary and fallopian tube).
- More extensive surgery may be needed for higher stages.
- Chemotherapy is essential: BEP regimen (bleomycin, etoposide, cisplatin) usually given in 3–4 cycles.
- Some patients who don’t respond to BEP may receive other regimens (e.g., cisplatin, ifosfamide, paclitaxel).
- In advanced cases, a heated chemotherapy technique called HIPEC (cisplatin and docetaxel) may be used after surgery.
- Supportive care helps manage chemotherapy side effects (e.g., medications to protect blood cell counts).

Prognosis
- Five-year survival is about 90–92%, higher than many other ovarian cancers, thanks to effective platinum-based chemotherapy.
- Recurrence after early-stage treatment occurs in about 15–25% of cases.