Using mainly histological analyses of fixed ovarian tissues and ultrasound imaging of ovaries in vivo, earlier imaging studies have established the basic framework of ovarian folliculogenesis as well as luteal formation and regression. Follicle detection and ovarian classification in digital. Abnormal gonads due to gonadal dysgenesis and androgen insensitivity syndrome have a high risk of developing a dysgerminoma. Nov 23, 2012 we report that the coincidence of ovarian tumor and pregnancy poses significant challenges that are more pronounced if the pregnancy is ectopic. The most commonly occurring gct is the dysgerminoma, which accounts for only 15% of all ovarian cancers. Preoperative imaging may depict local extension, peritoneal disease, and distant metastases. Ct findings of 11 cases with pathologically proved dysgerminoma of ovary were retrospectively analyzed.
Ovarian germ cell tumors usually occur in teenage girls or young women and most often affect just one ovary. A dysgerminoma refers to a class of tumor with germ cell origin. No radiological study has been done to compare the imaging findings between this type of. The condition usually first becomes apparent in adolescence with delayed puberty and primary amenorrhea. The image shows dysgerminoma of the ovary in a 39 yo female. Significant prognostic factors for causespecific mortality in ovarian dysgerminoma included age older than 40 years at diagnosis and metastatic disease. B positron emission tomographydualmodality computed tomography petct imaging of an ovary for. Ovarian dysgerminoma radiology reference article radiopaedia. She had no other treatment but her ca125 is and was being monitored. Hcg more commonly points to the possibility of an ectopic pregnancy rather than an ovarian malignancy. Sep 19, 2011 simple 46, xy gonadal dysgenesis syndrome, also called swyer syndrome, is known as pure gonadal dysgenesis. Pelvic mri may be needed if a nonovarian origin for the mass is suspected. The germinal epithelium of the ovary rests upon the ovarian stroma. Ultrasound software developed for calculating number, volume.
The cortex of the ovary has numerous primordial germ cells with relatively little stroma. Imaging findings of ovarian dysgerminoma with emphasis on. Ultrasound software developed for calculating number, volume of ovarian follicles software called sonographybased automated volume count provides an efficient method of calculating the number and volume of ovarian follicles. Epidemiology they are rare ovarian tumors that occ. Dysgerminoma disease staged below ia ie, confined within the capsule of only 1 ovary is best treated with simple unilateral salpingooophorectomy. They are the most common malignant germ cell tumors of the ovary and are thought to account for 1% of all ovarian neoplasms 5. Adjuvant therapy of completely resected dysgerminoma with carboplatin and etoposide.
Arvinder singh 1, surinderpal 2, sohan singh 1, aditi mahajan 1, mohit khandelwal 1 from the department of radiodiagnosis 1 and department of pathology 2, government medical college, amritsar, india. Transvaginal longitudinal grayscale image of the pelvis showing a. Attention to the presence of fatty tissue will contribute to making a correct di agnosis of teratoma, distinguishing it from other germ cell tumors. The results of this pilot study show that the most accurate and reproducible mr imagingbased diagnostic criterion for polycystic ovary syndrome in adolescents is an ovarian volume greater than 10.
Her left ovary was the size of a football the normal size is more like an almond. While imaging tests can reveal a tumor or other mass, they cant determine if its cancerous. Mri appearances of ovarian dysgerminoma sciencedirect. The pattern of spread for ovarian dysgerminomas often follows a lymphatic rather than peritoneal route, with up to 25% of patients having lymphatic involvement. Dysgerminoma in a case of 46, xy pure gonadal dysgenesis. An ovarian dysgerminoma is a rare, malignant tumor occurring in young women, accounting for 1% to 2% of all primary ovarian neoplasms. Using a fast 3d sequence with a spatial resolution of 1. Methodsct findings of 11 cases with pathologically. For example, in a series of 129 patients with ovarian dysgerminoma treated between 1983 and 1992, only 29 patients 22% underwent primary surgery in a specialized gynecological oncology center 9. We encountered a rare case of ovarian dysgerminoma in a 40yearold woman, whose preoperative mri findings consisted predominantly of hemorrhagic multilocules divided by unenhanced irregular septa. The microscopic appearance of ovarian dysgerminoma is identical to that of testicular seminoma and extragonadal germinoma.
Furthermore, in the limited studies available quantitative analysis was typically performed with inhouse written software 69,70. Mri, ct, and petct for ovarian cancer detection and adnexal. In a 14yearold female with dysgerminoma and coexisting gonadoblastomas, contrastenhanced magnetic resonance imaging mri demonstrated a solid mass in the right ovary, which presented as hyperintense lobules on diffusionweighted imaging separated by fibrovascular septa. Stage iv ovarian germ cell tumors treatment depends on whether the tumor is a dysgerminoma or another type of ovarian germ cell tumor. Ultrasound imaging, even if using color coded doppler technique may be inconclusive, though an enlarged ovary in association with whirlpool sign is diagnostic 3. Dec 23, 2019 a dysgerminoma is a tumor of the ovary that is composed of primitive, undifferentiated germ cells. Cns dysgerminoma ovarian dysgerminoma see also germ cell tumors.
Guerriero s1, testa ac, timmerman d, van holsbeke c, ajossa s, fischerova d, franchi d, leone fp, domali e, alcazar jl, parodo g, mascilini f, virgilio b, demidov vn, lipatenkova j, valentin l. In section, they appear to consist of different lobules, are soft and. Mri appearances of ovarian dysgerminoma researchgate. The patient was operated on and the mass was found to have arisen from the left ovary with no macroscopic invasion of surrounding structures. Dysgerminoma occurs in both ovaries in 10% of patients and, in a further 10%, there is microscopic tumor in the other ovary. The fat within the tumor demonstrated characteristic inte. Jun 15, 2015 ovarian yolk sac tumors ysts are rare neoplasms. Ovarian dysgerminoma is a common malignant tumor that comprises of ovarian germ cells. For the purpose of experimentation, the databases d1, d2 and d3, of ultrasound images of ovaries are prepared in consultation with the medical expert, namely, radiologist and gyneocologist, for the present study of the follicle detection and ovarian classification in ovarian images. No radiological study has been done to compare the imaging findings between this type of tumor and other ovarian tumors.
A biopsy should be performed on the contralateral ovary at the time of surgery if the ovary is enlarged or appears abnormal. Dysgerminomas are large average size 15 cm, lobulated, solid, soft fleshy tumors. Williams sd, kauderer j, burnett af, lentz ss, aghajanian c, armstrong dk. We examined in situ expression of stem cellrelated nanog, oct34, kit, ap2. A bmode ultrasound imaging showing the fuzzy outline of an ovary in an adult c57bl6 mouse.
The ovary contains individual follicles as functional structures, together with corpora lutea, interstitial tissues, innermost medulla and the outmost layer of. It is diagnosed by physical examination and imaging methods and is treated by salpingooophorectomy, radiation, and chemotherapy. Ct imaging of ovarian yolk sac tumor with emphasis on. Post contrast imaging can often show enhancement of the septae. Ovarian torsion is a possible cause of acute abdominal pain in women at any age, especially during their reproductive years 1,2.
Ovarian germ cell tumours ogcts typically arise in young females and their pathogenesis remains poorly understood. Tumors are often seen divided into lobules by septa. Clinical and ultrasound characteristics of ovarian dysgerminoma article in ultrasound in obstetrics and gynecology 375. Ovarian germ cell tumor is a disease in which malignant cancer cells form in the germ egg cells of the ovary. A diagnosis of ovarian dysgerminoma is rarely suspected before surgery. Therefore, complete lymphadenectomy should be performed. The ovarian stroma is more abundant in the medulla, where the larger follicles are seen. Magnetic resonance mr imaging characteristics of ovarian cystic teratomas were evaluated in 18 patients with 23 surgically proved tumors.
The lesion was almost entirely solid with small cystic component. Individuals with the syndrome are characterized by 46, xy karyotype and phenotypically female with female genital appearance, normal mullerian structures and absent testicular tissue. Germ cell tumors begin in the reproductive cells egg or sperm of the body. In a 14yearold female with dysgerminoma and coexisting gonadoblastomas, contrastenhanced magnetic resonance imaging mri. Dysgerminomas are malignant germ cell tumors of the ovary that most. We report the imaging findings of three ovarian dysgerminomas that coexisted with other germ cell tumors or gonadoblastomas, focusing on the distribution of tumor nests and vascular architecture, which might provide information about the pathogenesis of dysgerminomas. Simply select your manager software from the list below and click on download. Ultrasound in follicle monitoring for ovulation inductioniui fig. A tumor of the identical histology but not occurring in the ovary may be described by an alternate name. Massive ovarian dysgerminoma presenting as an unusual large intraabdominal mass. Ct characteristics of ovarian dysgerminoma springerlink. Summary mri appearances of a 19yrold woman with solid mature teratoma of the ovary is presented. T2weighted mr imaging showed a hypointense signal, corresponding to.
Cross sectional imaging plays a crucial role in diagnosis, tumor staging. Ovarian germ cell tumor dysgerminoma cleveland clinic. However, the lesscommon histologic types of primary ovarian malignancies, such as brenner tumor, dysgerminoma, or granulosa cell tumor fig. Ultrasound in follicle monitoring for ovulation inductioniui. Hi, i just wanted to say that my stepdaughter was diagnosed at 16 with ovarian dysgerminoma. The imaging features of the mass were almost the same as in the first patient. Age and sex distribution ovarian dysgerminoma is the tumor of young individuals and about 90% of the ovarian dysgerminomas can occur before the age of 30 years.
In addition, a second cancer occurred in 10% of all patients who survived to 10 years and had received radiotherapy compared to 2% of those who had not received radiation treatment p. The most common ovarian germ cell tumors are dysgerminomas, which. Here, we report a rare and interesting case of a 24yearold nulliparous spanish woman who experienced the coincidental occurrence of left tubal pregnancy and dysgerminoma in the right ovary. The mean average age of occurrence of dysgerminoma of ovary is around 22 years. Full surgical staging is recommended for ovarian germ cell tumors gcts to identify women with greater than stage ia disease. The potential of magnetic resonance imaging mri was evaluated in 21 female subjects. Treatment of dysgerminoma may include the following.
After contrast medium administration, the solid component of the lesions showed. Massive ovarian dysgerminoma presenting as an unusual large. Total abdominal hysterectomy and bilateral salpingooophorectomy followed by chemotherapy, with removal of as much of the cancer in the pelvis and abdomen as possible. One preliminary study demonstrated feasibility of dcemri in ovarian cancer and peritoneal deposits also on a 3 t unit. Ovarian dysgerminomas are characteristically solid and well.
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Jan 23, 2020 treatment of malignant germ cell tumors of the ovary with bleomycin, etoposide, and cisplatin. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Ovarian dysgerminomas are characterised by frequent kit. Ovarian dysgerminoma and synchronic contralateral tubal. A simple left salpingooophrectomy was done followed by radiotherapy and chemotherapy. The tumor presented as a solid n 8 or cysticsolid n 3 mass. On mri, they can sometimes be distinguished from the benign lesions because they originate from the ovary unlike a fibroid, show heterogeneity in tissue. Germ cell tumors arise from primordial germ cells of the ovary and the testis. Figure 1 different techniques for realtime live imaging of the ovary.
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