GERM CELL TUMOURS OF THE OVARY
Germ cell tumors constitute about 15–20 percent of all ovarian neoplasms and they are the second common ovarian tumors. They have got varying degrees of malignant potentiality.
About 3 percent of these tumors are malignant. Germ cell tumors occur predominantly in children and young adults. They arise from embryonic germ cells.
Dysgerminoma is the commonest (30–40%) malignant germ cell tumor. It arises from undifferentiated form of germ cells. It is often (5%) associated with dysgenetic gonad. The counterpart of dysgerminoma in male is seminoma. Majority (75%) of the tumors occur before the age of 30 years. hCG assays are often positive, confusing the diagnosis with pregnancy. It may coexist with pregnancy (20–30%). Dysgerminoma may be associated with choriocarcinoma or endodermal sinus tumor. Tumor markers α-fetoprotein (AFP) and hCG may be positive in that situation. Karyotyping is needed specially when a premenarcheal girl presents with a pelvic mass.
Pathology: The shape is usually round or oval and is usually 5–15 cm in diameter; feel is boggy, at times, it is firm rubbery. It may be bilateral (10%).
Cut section shows pink or yellow color. Microscopic appearance reveals uniform large round cells (monotonous pattern), arranged in cords or clumps with abundant clear cytoplasm. Nuclei are large, irregular and hyperchromatic with varying degree of mitosis. There is intense infiltration of lymphocytes and plasma cells in the fibrous septum. In more than 50 percent, they are potentially malignant.
CLINICAL FEATURES:- Clinical features are not specific for the tumor.
The medicines that can be thought of use are:-
- Bufo Rana
- Lilium tigrinum