Ovarian dysgerminoma

Last revised by Dr Ammar Haouimi on 05 Dec 2020

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

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

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

The tumors are usually hormonally inert 4 and in their pure form 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. LDH can also be raised making it useful in diagnosis and post-operative follow-up of ovarian dysgerminoma 6.

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

Approximately 10-17% of tumors can be bilateral.

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

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.

Tumors 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 

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Cases and figures

  • Case 1: Ovarian dysgerminoma
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