Abstract
Germ cell tumors represent 20 to 30% of all ovarian tumors in adults and are classified according to the World Health Organization classification. Although most types of germ cell tumors occur in pure form, each of them may also be mixed with one or more other types. The prognosis of a mixed germ cell tumor generally reflects that of its most malignant element, but a small focus of high malignancy does not influence the prognosis as adversely as a large component. Mixed tumors contain at least two different malignant germ cell components. The appearance of a malignant mixed germ cell tumor varies according to its individual constituents, but it is generally a complex, predominantly solid tumor, as are the other germ cell tumors. Computed tomography (CT) is very useful for detecting a malignant transformation either in the Rokitansky protuberance or in the cyst wall. On CT scan, calcifications scattered throughout the tumor and small amounts of adipose tissue can be displayed and highly suggest the diagnosis of immature teratoma. In the case of CT of dysgerminoma, calcifications can be visualized with a speckled pattern.
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