Ovarian dysgerminoma

Ovarian dysgerminomas are a type of germ cell tumour of the ovary. They are the most common malignant germ cell tumours of the ovary and are thought to account for ~1% of all ovarian neoplasms 5.

They are rare ovarian tumours that occur predominantly in young women (majority occurring in the 2nd to 3rd decades 5).  Approximately 10-20 of cases can occur in pregnancy.

The tumour is thought to arise from primordial germ cells and is considered an ovarian counterpart of seminoma of the testis. They are usually solid and multi-lobulated.

Markers

The tumours are usually hormonally inert  4 and in its pure form is not associated with endocrine hormone secretion. However, syncytiotrophoblastic giant cells, which produce HCG, are present in 5% of dysgerminomas and can cause elevation of serum HCG levels.

Variants

Approximately 15% of tumours can contain other malignant germ cell variants in which instance they are termed malignant mixed germ cell tumours of the ovary 5.

Laterality

Approximately 10-17% of tumours can be bilateral.

Ultrasound

May be seen as a septated ovarian mass with varying echotexture. Colour Doppler interrogation may show prominent flow signal within the fibrovascular septa 2.

CT

Calcification may be present in a speckled pattern. Characteristic imaging findings include multilobulated solid masses with prominent fibrovascular septa. Post contrast imaging can often show enhancement of the septae.

MRI

Tumours are often seen divided into lobules by septa.

Reported signal characteristics include:

  • T2: the septae are often hypointense or isointense 3
  • T1 C+ (Gd): the septae often show marked enhancement 3 
Germ cell tumours
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Article Information

rID: 14287
System: Gynaecology
Tag: cases
Synonyms or Alternate Spellings:
  • Dysgerminoma of the ovary
  • Dysgerminoma of ovary
  • Ovarian germinoma
  • Germinoma of the ovary

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