Clinicopathologic characteristics of malignant germ cell tumors of ovary / 대한산부인과학회지

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the clinicopathologic characteristics of malignant germ cell tumors of ovary. METHODS: Thirty five patients who were dignosed as malignant germ cell tumors of ovary and treated in Cheil General Hospital from January 1995 to December 2003, were retrospectively analyzed. The age, chief complaints, histologic type, tumor marker, FIGO stage, maximal tumor diameter, management, survival and future pregnancy outcome were reviewed. RESULTS: The mean age was 23.4 years (8-34) and 2 patients were premenarche. The mean follow-up period was 59.6 months (16-118). Palpable lower abdominal mass and pain were the most frequent symptoms. Preoperative CA125 were checked in 32 patients and elevated in 23 patients . The tumors were ranging from 7cm to 27cm in diameter (mean 16.6). The site of tumors was right-sided in 17(48.6%), left-sided in 15(42.9%), and bilateral in 3(8.6%) which were dysgerminomas only. Post-surgical FIGO stage was stage I in 28 cases (80.0%), stage II in 4 cases (11.4%), and stage III in 3 cases (8.6%). Histologically, immature teratomas were found most frequently (n=14, 40.0%), followed by dysgerminoma (n=10, 28.6%), endodermal sinus tumor (n=9, 25.7%), and mixed form (n=2, 5.7%). Unilateral salpingo-oophorectomy was performed in 9, cystectomy in 4, and staging operation in 22, which included 16 patients of fertility sparing operation. Postoperative chemotherapy was administered in 30 and most were BEP except one TIP. Two patients had recurred, who were stage Ic and IIIb EST at diagnosis and expired at 59 and 16 months after first operation. Recurrence rate was 5.7% and 5-year survival rate was 94.7%. During follow-up period, 8 patients were pregnant and the results were 4 normal deliveries at term, 1 missed abortion, 1 therapeutic abortion due to acne medication, 1 H-mole and 1 current pregnant state at 20 weeks without problem. CONCLUSION: These results shows that most malignant germ cell tumors of ovary is detected in early stage and have relatively excellent survival with conservative operation and combination chemotherapy.