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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.
Approximately 10-17% of tumors can be bilateral.
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.
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.
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
- 1. Jung SE, Lee JM, Rha SE et-al. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 22 (6): 1305-25. doi:10.1148/rg.226025033 - Pubmed citation
- 2. Kim SH, Kang SB. Ovarian dysgerminoma: color Doppler ultrasonographic findings and comparison with CT and MR imaging findings. J Ultrasound Med. 1995;14 (11): 843-8. J Ultrasound Med (abstract) - Pubmed citation
- 3. Tanaka YO, Kurosaki Y, Nishida M et-al. Ovarian dysgerminoma: MR and CT appearance. J Comput Assist Tomogr. 18 (3): 443-8. - Pubmed citation
- 4. Song ES, Lee JP, Han JH et-al. Dysgerminoma of the ovary with precocious puberty: a case report. Gynecol. Endocrinol. 2007;23 (1): 34-7. - Pubmed citation
- 5. Nucci MR, Oliva E. Gynecologic Pathology. Churchill Livingstone. (2009) ISBN:0443069204. Read it at Google Books - Find it at Amazon
- 6. Suk Hee Heo, Jin Woong Kim, Sang Soo Shin, et al. Review of Ovarian Tumors in Children and Adolescents: Radiologic-Pathologic Correlation. (2014) RadioGraphics. doi:10.1148/rg.347130144