Malignant Ovarian Germ Cell Tumors Research Articles

Outcomes after bleomycin, etoposide and cisplatin combination chemotherapy in patients with ovarian yolk sac tumor

Objective: The aim of this study was to evaluate the oncologic and reproductive outcomes of patients with ovarian yolk sac tumor after bleomycin, etoposide, cisplatin (BEP) chemotherapy following surgery. Methods: Of 145 patients with histologically confirmed malignant ovarian germ cell tumor, 43 had yolk sac tumor and received BEP chemotherapy after surgery. A retrospective analysis of these patients was performed. Results: The mean age of 43 patients was 24.8 years (range, 7 to 59 years). Thirty eight patients were iparous. Of 179 BEP chemotherapy cycles, grade 1~2 hematologic and non-hematologic adverse events occurred in 46 cycles in 21 patients. Thirty nine patients showed complete remission, 1 patient showed partial remission, and 3 patient had progressive disease during BEP chemotherapy. After median follow-up time of 57 months (range, 3 to 153 months), 5 patients had recurrent disease and three of them died of disease. The 5-year recurrence free survival rate and overall survival rate were 86% and 94%, respectively. After chemotherapy, all but one premenarchal patients had normal menstruation. Of them 5 patients tried to conceive and 3 of them succeeded in pregnancy. Conclusion: BEP chemotherapy was very safe and effective in patients with ovarian yolk sac tumor. Survival outcomes are excellent and reproductive outcomes are promising after BEP chemotherapy.

Oestrogen receptors and small nuclear ring finger protein 4 (RNF4) in malignant ovarian germ cell tumours

The peak incidence of malignant ovarian germ cell tumours occurs soon after puberty. Thus, gonadal steroids may play a role in their development. Oestrogen receptors (ERα and ERβ) and their co-regulators, including small nuclear ring finger protein 4 (SNURF/RNF4) mediate oestrogen actions. While ERβ and SNURF are down-regulated in testicular germ cell tumours, their role in the ovarian germ cell tumours remains unknown.We herein studied the different subtypes of malignant ovarian germ cell tumours, and found that they all express ERα, ERβ, and SNURF. Stimulation with oestradiol (E2), ERα, ERβ and SNURF significantly up-regulated mRNA expression in the human germinoma derived NCC-IT cells. Further, the effects of E2 were counteracted by an anti-oestrogen (ICI 182,780). Neither E2 nor ICI 182,780 had an effect on the proliferation of NCC-IT cells as assessed by flow cytometric analysis. Our results suggest that oestrogen signalling has a role in malignant ovarian germ cell tumours.

Malignant Ovarian Germ Cell Tumors

To evaluate the clinicopathologic prognostic factors in malignant ovarian germ cell tumors. We reviewed the medical records of 70 patients treated from 1990 to 2006 at our center. Clinical data including demographics, stage, surgery, chemotherapy, survival, menses status, and fertility were collected from patients' charts. Median age was 22 years (range, 9-68). The histologic subtypes included 36 dysgerminomas, 11 yolk sac tumors, 3 immature teratomas, 1 embryonal carcinomas, and 19 mixed types. The most striking clinicopathologic finding was a history of concomitant immunosuppressant therapy, which was observed in 2 patients. Two patients had contralateral sex-cord tumors at presentation and follow-up. During a median follow-up period of 4.6 years, 11 patients had recurrence. The median time to recurrence was 8 months (6-28 months). Recurrences appeared in the abdominopelvic cavity in 9 out of 11 patients. Only one could be salvaged with second-line chemotherapy. Cumulative survival rate was 97% and 60% in patients with dysgerminoma and nondysgerminoma, respectively. Nondysgerminoma histology and residual tumor after surgery were unfavorable prognostic factors (P < 0.001 and P = 0.015). Fertility-sparing surgery was as effective as radical surgery among all eligible patients. Of patients with known menstrual status, 96% had regular menses. Of the 8 patients who opted for conception among these patients, 7 delivered healthy infants. Nondysgerminomas have an aggressive clinical course. New treatment strategies are needed for eradication of abdominopelvic disease at initial diagnosis and recurrent setting. Occurrence of malignant ovarian germ cell tumors may be associated with immunosuppression in some patients. Sex-cord stromal tumors may present with bilateral involvement. It is possible to maintain fertility after fertility-sparing surgery followed by chemotherapy.

Outcome and reproductive function after cumulative high-dose combination chemotherapy with bleomycin, etoposide and cisplatin (BEP) for patients with ovarian endodermal sinus tumor

Objective The aim of this study was to investigate the outcome and reproductive function of patients with ovarian endodermal sinus tumor (EST) after cumulative high-dose combination chemotherapy with bleomycin, etoposide and cisplatin (BEP). Methods Between 1995 and 2006, 1034 patients with the diagnosis of ovarian cancer were treated at a single institution. Among these patients, 51 had a confirmed diagnosis of malignant ovarian germ cell tumor (MOGCT) including 20 cases of EST. We retrospectively reviewed those patients with EST, who received BEP as adjuvant chemotherapy. The doses were 15 mg/day of bleomycin on days 1 to 3, 100 mg/m 2/day IV of etoposide on days 1 to 3 and 20 mg/m 2/day of cisplatin on days 1 to 5. The median number of total cycles was six (range between three and nine). Results The median age of the patients with EST was 18 years (range 5 to 36). All except two were nulliparous. The overall survival rate was 90% at a median follow-up of 70 months. Two patients (10%) had disease recurrence in the pelvis. Of the 15 patients who were treated with fertility-sparing surgery, all had regular menstruation following the completion of adjuvant chemotherapy, and two of these patients had pregnancies with live birth deliveries and no complications. Conclusion In patients with EST, the cumulative high-dose BEP regimen resulted in excellent overall survival and did not seem to impair ovarian function.

The influence of conservative surgical practices for malignant ovarian germ cell tumors

To evaluate demographics, survival, and surgical trends for patients with malignant ovarian germ cell tumors. SEER data abstracted from 1988 to 2001 and analyzed using Kaplan-Meier and Cox regression models. Of 760 patients, the median age was 23 years. Seventy-six percent of patients presented with stage I-II disease, and 24% with stage III-IV. Fifty-five percent were immature teratomas, 32% dysgerminomas, and 13% yolk sac tumors. Fertility-preserving surgery was performed in 41.2% (n = 313) of patients. In those <45 years old, the use of fertility-preserving surgery increased from 40.5% to 44.5% to 48.4% over the time periods 1988-1992, 1993-1997, 1998-2001 (P = 0.25). The survival of patients who underwent fertility-preserving surgery was not statistically different compared to those who underwent standard surgery (P = 0.26). Patients with stage I-II disease had improved survival compared to stage III-IV disease (97.6% vs. 85.5%, P < 0.001). The overall survival of women with dysgerminomas, immature teratomas, and yolk sac tumors was 99.5%, 94.3%, and 85.4%, respectively (P < 0.001). In multivariate analysis, older age, advanced stage, and yolk sac tumor histology predicted for poorer survival. Our data suggests that the use of fertility-preserving surgery with concomitant surgical staging for germ cell cancers has increased without compromising survival.

Malignant ovarian germ cell tumors: A retrospective analysis of the Russian Cancer Research Center

16105 The aim of this study was to analyse treatment results of patients with malignant ovarian germ cell tumors (MOGCT) between 1990 and 2006. A total of 117 patients with MOGCT were retrospective...

Ovarian carcinoma associated with pregnancy: A clinicopathologic analysis of 23 cases and review of the literature

BackgroundThe aim of this study was to analyze and describe cases of ovarian cancer in pregnant women treated at our center and to review the literature concerned, and to discuss the rationale for therapy.MethodsTwenty-Three patients of ovarian malignancies during pregnancy were treated at Vali- Asr Hospital between 1991 and 2002. Data on treatment and follow-up were evaluated.ResultsThe incidence of ovarian carcinoma associated with pregnancy in our series was 0.083/1000 deliveries. Eleven (47.8%) were found with ovarian malignant germ cell tumors, five (21.7%) with low malignant potential tumors, four (17.4%) with invasive epithelial tumors, and three (13%) with sex cord stromal tumors. Seventeen (73.9%) of the patients were diagnosed in stage I and had complete remission. Five of the six in advanced stage died. The mean follow-up was 36.3 months. The prognosis was significantly related with stage and histological type (P < 0.05). Sixteen healthy live babies were recorded in this group, and two premature newborn died of respiratory distress syndrome. Chemotherapy was administered to 44% of the patients, in two cases during pregnancy. Overall survival at 5 years was 61%. In most of case conservative surgical treatment could be performed with adequate staging and debulking.ConclusionEarly finding of ascitis by ultrasound and persistent large ovarian mass during pregnancy may be related to malignancy and advanced stage. Pregnant women in advanced stage of ovarian cancer seem to have poor prognosis.

A review of the close surveillance policy for stage I female germ cell tumors of the ovary and other sites

Ovarian germ cell tumors are rare but very curable at all stages of disease. There is good evidence that surveillance for stage I dysgerminomas is a safe option although many centers worldwide still advocate adjuvant chemotherapy for stage IA nondysgerminomatous tumors, despite the significant risk of developing long-term treatment side effects. Here, we review the safety of our ongoing surveillance program of all stage IA female germ cell tumors. Thirty-seven patients (median age 26, range 14–48 years) with stage I disease were referred to Mount Vernon and Charing Cross Hospitals between 1981 and 2003. Patients underwent surgery and staging followed by intense surveillance, which included regular tumor markers and imaging. The median period of follow-up was 6 years. Relapse rates for stage IA nondysgerminomatous tumors and dysgerminomas were 8 of 22 (36%) and 2 of 9 (22%), respectively, plus one patient with mature teratoma and glial implants also relapsed; 10 of these 11 patients (91%) were successfully cured with platinum-based chemotherapy. Only one patient died from chemoresistant disease. All relapses occurred within 13 months of initial surgery. The overall disease-specific survival of malignant ovarian germ cell tumors was 94%. Over 50% of patients who underwent fertility-sparing surgery went on to have successful pregnancies. We have confirmed again that surveillance of all stage IA ovarian germ cell tumors is very safe and that the outcome is comparable with testicular tumors. We question the need for potentially toxic adjuvant chemotherapy in nondysgerminoma patients who have greater than 90% chance of being salvaged with chemotherapy if they relapse later.

Management of Ovarian Germ Cell Tumors

To review contemporary management of malignant ovarian germ cell tumors (MOGCT). The literature on the topic of MOGCT is reviewed, including pathology, prognostic factors, surgical strategies, postoperative therapy, late effects of therapy, and treatment of recurrence. Prognostic factors for MOGCT include the International Federation of Gynecology and Obstetrics staging system's stage, residual disease, histologic type, and elevation of serum tumor markers. Fertility-sparing surgery is possible in a large proportion of patients. The importance of comprehensive surgical staging is somewhat controversial. For patients with advanced-stage disease, maximum cytoreductive surgery appears to be beneficial. Although second-look surgery is not recommended routinely, selected patients may benefit from secondary cytoreduction. For those patients who require postoperative chemotherapy, standard therapy consists of the combination of bleomycin, etoposide, and cisplatin. However, there is a growing trend toward surveillance; this strategy continues to be studied. Although premature menopause may occur in a small proportion of patients, at least 80% of those who undergo fertility-sparing surgery and chemotherapy may expect to preserve reproductive function. For patients with early-stage disease, cure rates approach 100%. For those with advanced-stage disease, cure rates are reportedly at least 75%. MOGCT is a rare malignancy that principally affects girls and young women. With optimal therapy, the prognosis is excellent, and most patients may retain reproductive function.

Reproductive and Sexual Function After Platinum-Based Chemotherapy in Long-Term Ovarian Germ Cell Tumor Survivors: A Gynecologic Oncology Group Study

To compare malignant ovarian germ cell tumor survivors with a matched control group of females on menstrual and reproductive outcomes, sexual functioning, and dyadic adjustment. Eligible patients met the following criteria: (1) history of malignant ovarian germ cell tumor; (2) treatment with surgery plus platinum-based chemotherapy; (3) age at least 18 years and continuously disease-free with minimum follow-up of 2 years; (4) capability of completing questionnaire and telephone interview; and (5) completion of written informed consent. The control group was drawn from acquaintances recommended by survivors and matched for age, race, and education. Scales with established reliability and validity were used to measure quality-of-life concepts of sexual functioning and social networks. One hundred thirty-two survivors and 137 controls completed the study. Of 132 survivors, 71 (53.8%) had fertility-sparing surgery. Of fertile survivors, 62 (87.3%) reported still having menstrual periods. Twenty-four survivors reported 37 offspring after cancer treatment. Compared with controls, survivors had significantly greater reproductive concerns (P < .0001), less sexual pleasure (P = .003), and lower scores on the total Sexual Activity Scale Score (P = .001). However, survivors had better dyadic consensus (P = .004), dyadic satisfaction (P = .005), and dyadic cohesion (P = .014). Women who had fertility-sparing surgery were very likely to retain menstrual function and fertility after chemotherapy. Although there is some increase in gynecologic symptoms and diminution in sexual pleasure, survivors tended to have stronger, more positive relationships with significant others.

Fertilitätserhaltung und Ovarprotektion bei Tumorerkrankungen: Bereits ein Standard?

Die Therapie gynäkologischer und nicht gynäkologischer Tumoren bei prämenopausalen Patientinnen steht in unmittelbarem Zusammenhang mit der Erhaltung der Fertilität bzw. der ovariellen Hormonproduktion. So werden beim prämenopausalen Mammakarzinom derzeit die Ovarprotektion mit GnRH-Agonisten, Kryokonservierung von Ovarialgewebe, Eizellen oder Embryonen diskutiert. Beim Mammakarzinom gibt es derzeit keine evidenzbasierte Empfehlung für die Erhaltung der Fertilität oder Ovarialfunktion. Mit Ausnahme der Kryokonservierung von befruchteten Eizellen sind alle anderen Verfahren experimentell. Insbesondere ist die wiedereinsetzende Hormonproduktion und deren möglicher negativer Einfluss auf okkulte hormonrezeptorpositive Tumorzellen noch unklar. Patientinnen mit einer chemotherapieinduzierten Amenorrhö scheinen gegenüber weiter menstruierenden Frauen einen Vorteil im Überleben zu haben. Bei gut differenzierten Frühstadien des Endometriumkarzinoms (G1) und fehlender Myometriuminfiltration ist eine zeitlich begrenzte Remission unter Gestagen, mit nachfolgender Schwangerschaft, möglich. Die radikale vaginale Trachelektomie beim frühen Zervixkarzinom (FIGO Ia - b1) stellt eine Option zur Fertilitätserhaltung dar, wobei als wesentlicher Nachteil Zervixstenosen und die hohe Rate an Frühgeburten zu nennen ist. In Abhängigkeit vom FIGO-Tumorstadium, Grading, Ploidie-Status, histologischem Subtyp und dem Wunsch der Patientin ist bei Borderline-Tumoren, FIGO Ia(-c)-Ovarialkarzinomen und malignen Keimzelltumoren ein organerhaltendes Vorgehen mit einfacher Tumorektomie, ein- oder beidseitiger Ovarteilresektion oder unilateraler Adnexexstirpation möglich. Die Rezidivrate nach organerhaltender Operation eines Borderline- oder FIGO Ia low-grade Tumors sind mit 10 % gegenüber radikaler OP erhöht, während das Gesamtüberleben vergleichbar ist. Bei nicht gynäkologischen Tumoren geht es um den Schutz der Ovarien vor Radiatio und Chemotherapie. Hierzu können alle genannten Verfahren Anwendung finden, wobei die wiedereinsetzende Hormonproduktion keine Bedeutung hat.

A review of the close surveillance policy for stage I female germ cell tumors of the ovary and other sites

Ovarian germ cell tumors are rare but very curable at all stages of disease. There is good evidence that surveillance for stage I dysgerminomas is a safe option although many centers worldwide still advocate adjuvant chemotherapy for stage IA nondysgerminomatous tumors, despite the significant risk of developing long-term treatment side effects. Here, we review the safety of our ongoing surveillance program of all stage IA female germ cell tumors. Thirty-seven patients (median age 26, range 14-48 years) with stage I disease were referred to Mount Vernon and Charing Cross Hospitals between 1981 and 2003. Patients underwent surgery and staging followed by intense surveillance, which included regular tumor markers and imaging. The median period of follow-up was 6 years. Relapse rates for stage IA nondysgerminomatous tumors and dysgerminomas were 8 of 22 (36%) and 2 of 9 (22%), respectively, plus one patient with mature teratoma and glial implants also relapsed; 10 of these 11 patients (91%) were successfully cured with platinum-based chemotherapy. Only one patient died from chemoresistant disease. All relapses occurred within 13 months of initial surgery. The overall disease-specific survival of malignant ovarian germ cell tumors was 94%. Over 50% of patients who underwent fertility-sparing surgery went on to have successful pregnancies. We have confirmed again that surveillance of all stage IA ovarian germ cell tumors is very safe and that the outcome is comparable with testicular tumors. We question the need for potentially toxic adjuvant chemotherapy in nondysgerminoma patients who have greater than 90% chance of being salvaged with chemotherapy if they relapse later.

Tumeurs germinales malignes de l'ovaire. À propos de 36 cas

Objective With personal results and a review of the literature, we report the eventual interest of surgical staging in malignant ovarian germ cell tumours. Patients and methods This was a retrospective study of 36 patients (21.5–[8–61]) with malignant ovarian germ cell tumours between January 1984 and December 2004. There were 4 groups: n o 1 – dysgerminoma only, n o 2 – immature teratoma, n o 3 – malignant ovarian germ cell tumours with secretion. All the patients had a minimal follow up of 18 months after treatment. We reported conservative or non-conservative surgery, if surgical staging was made and description of eventual neoadjuvant or adjuvant chemotherapies and finally the recurrences and deaths. Results Stages of FIGO were: group 1 – IA n = 2, IC n = 2, IIB n = 1, IIIA n = 2, IIIC n = 3; group 2 – IA n = 3 (G1, G2, G2), IC n = 1 (G3); group 3 – IA n = 8, IC n = 4, IIA n = 1, IIIA n = 1, IIIB n = 3, IIIC n = 5. Three patients had neoadjuvant chemotherapy. All the patients had cytoreductive surgery (conservative surgery n = 31) with staging in 15 cases. Twenty-six patients had adjuvant chemotherapy. Five years global survival was 92%. Discussion and conclusion Surgery in a young patient with malignant ovarian germ cells tumours must be conservative (adnexectomy) (preserving fertility and because of good prognostic). In case of stage IA with part of dysgerminoma and/or immature teratoma and/or embryonal carcinoma certified by surgical staging, strict follow up could be organized (clinic, radiology, AFP, HCG). In case of more than stage IA, chemotherapy is indicated after conservative surgery and surgical staging.

Ovarian dysgerminomas are characterised by frequent KIT mutations and abundant expression of pluripotency markers

BackgroundOvarian germ cell tumours (OGCTs) typically arise in young females and their pathogenesis remains poorly understood. We investigated the origin of malignant OGCTs and underlying molecular events in the development of the various histological subtypes of this neoplasia.ResultsWe examined in situ expression of stem cell-related (NANOG, OCT-3/4, KIT, AP-2γ) and germ cell-specific proteins (MAGE-A4, NY-ESO-1, TSPY) using a tissue microarray consisting of 60 OGCT tissue samples and eight ovarian small cell carcinoma samples. Developmental pattern of expression of NANOG, TSPY, NY-ESO-1 and MAGE-A4 was determined in foetal ovaries (gestational weeks 13–40). The molecular genetic part of our study included search for the presence of Y-chromosome material by fluorescence in situ hybridisation (FISH), and mutational analysis of the KIT oncogene (exon 17, codon 816), which is often mutated in testicular GCTs, in a subset of tumour DNA samples. We detected a high expression of transcription factors related to the embryonic stem cell-like pluripotency and undifferentiated state in OGCTs, but not in small cell carcinomas, supporting the view that the latter do not arise from a germ cell progenitor. Bilateral OGCTs expressed more stem cell markers than unilateral cases. However, KIT was mutated in 5/13 unilateral dysgerminomas, whereas all bilateral dysgerminomas (n = 4) and all other histological types (n = 22) showed a wild type sequence. Furthermore, tissue from five phenotypic female patients harbouring combined dysgerminoma/gonadoblastoma expressed TSPY and contained Y-chromosome material as confirmed by FISH.ConclusionThis study provides new data supporting two distinct but overlapping pathways in OGCT development; one involving spontaneous KIT mutation(s) leading to increased survival and proliferation of undifferentiated oogonia, the other related to presence of Y chromosome material and ensuing gonadal dysgenesis in phenotypic females.

Evaluation the effect of fertility-preserving surgery on young patients with malignant ovarian tumors

To evaluate the impact of fertility-saving surgery and adjuvant chemotherapy on survival and fertility of young patients with ovarian malignant tumors. A retrospective analysis was done on 38 patients with ovarian malignant germ cell tumors, 22 patients with malignant epithelial tumors and 4 patients with sexual cord mesenchymal tumors receiving conservative treatments. Outcomes such as menstruation and reproduction ability were assessed. Fifty-nine among 64 patients have been alive up to now (92%). The overall survival rate for ovarian epithelial malignancies, malignant germ cell tumors and sexual cord mesenchymal tumors were 95% (21/22), 89% (34/38) and 4/4, respectively. Fifteen patients received second operation and recurrence was found in 6 patients. Among the 59 surviving patients, 53 had normal menstruation. Thirteen patients among 20 patients who wanted to get pregnant had 15 pregnancies and 9 successful deliveries. The management of fertility-saving surgery on patients with ovarian malignant germ cell tumors, whatever the stagings are, is a safe option. For patients with ovarian epithelial carcinomas, fertility-saving surgery is only indicated for low-stage (stage I), high-grade (G1), and patients who hope to maintain fertility function eagerly. Cisplatinum-based combination chemotherapy is necessary. Standardized chemotherapy has no effect on fertility function.

Significance of cyclin E and p27 expression in malignant ovarian germ cell tumors: Correlation with the cell proliferation activity and clinicopathologic features

Although elevated cell proliferation activity is one of the most remarkable features known to characterize malignant ovarian germ cell tumors (MOGCTs), abnormalities in cell cycle regulation have yet to be thoroughly investigated in MOGCTs. Forty-two MOGCTs were immunohistochemically examined to determine their cyclin E and p27Kip1 (p27) expression in correlation with their cell proliferation activity and clinicopathological features. Cytosine methylation of p27 gene promoter CpG islands was estimated by methylation-specific PCR. The labeling index (LI) was calculated as a percentage of the positively stained tumor cells per total tumor cells counted. p27 LIs showed a significant inverse correlation with Ki-67 LIs in MOGCTs examined (p<0.05). The cyclin E LIs of yolk sac tumors were significantly higher than those of dysgerminomas (p<0.01). Two MOGCTs were methylation-positive (5%). Both p27 and cyclin E are thought to be involved in the cell cycle regulation of MOGCTs. p27 gene promoter methylation is rare in MOGCTs. An immunohistochemical evaluation of cyclin E may be a useful diagnostic modality for differentiating MOGCTs.

Malignant Ovarian Germ Cell Tumors: Identification of Novel Prognostic Markers and Long-Term Outcome After Multimodality Treatment

Malignant ovarian germ cell tumors are rare and knowledge about prognostic parameters currently is limited. This study was undertaken to evaluate long-term outcome of patients with malignant ovarian germ cell tumors (MOGCTs) after chemotherapy and to assess prognostic parameters. A total of 113 patients with stage IC to IV MOGCTs were included into this retrospective study. Patients were treated at two large regional cancer centers between 1977 and 2003. Ten-year recurrence-free and overall survival rates were 82% and 81%, respectively. A total of 20 patients experienced relapse, all within the first 8 years. Outcome after relapse was poor, with only 10% of patients achieving long-term survival. Univariate and multivariate analyses demonstrated that initial stage of disease (relative risk [RR], 5.96; 95% CI, 3.47 to 10.22; P = .03) and elevation of serum markers beta-human chorionic gonadotropin and alpha-fetoprotein (RR, 3.90; 95% CI, 1.40 to 10.9; P = .009) were significant predictors of overall survival, whereas age at diagnosis was of no prognostic value. This is the first study to identify stage and tumor markers as prognostic parameters for patients with MOGCTs. This might help to select patients for risk-adapted treatment. There is need for improvement of therapeutic strategies after relapse.

0211: Comparative Study of Treatment Modalities for Ovarian Malignant Germ Cell Tumors (Omgct) in Korea Multicenter Retrospective Study

0211: Comparative Study of Treatment Modalities for Ovarian Malignant Germ Cell Tumors (Omgct) in Korea Multicenter Retrospective Study

A successful IVF–pregnancy in a patient who underwent conservative surgery followed by a regimen of cisplatin, vinblastine and peplomycin to treat an advanced ovarian mixed germ cell tumour: A Case Report

Mixed germ cell tumours of the ovary, one type of malignant ovarian germ cell tumours (MOGCTs), are rare gynaecologic cancers usually affecting young women. We report the case of a patient with an advanced ovarian mixed germ cell tumour who underwent fertility-saving surgery followed by a chemotherapy regimen of cisplatin, vinblastine and peplomycin. The patient was disease-free 8 years after initial presentation. She conceived and gestated dichorionic twins after IVF-embryo transfer. To the best of our knowledge, the patient is the first to be treated successfully with the combination chemotherapy regimen and then conceive safely using assisted reproductive technology (ART).

Chromosome 12p abnormalities in dysgerminoma of the ovary: a FISH analysis

Dysgerminoma is the most common malignant ovarian germ cell tumor and shares histological and immunophenotypical features with its testicular counterpart, seminoma. Chromosome 12p abnormalities are genetic hallmarks of testicular seminomas. Little is known about these genetic changes in dysgerminoma. We performed dual color fluorescence in situ hybridization (FISH) analyses with a centromeric α-satellite probe for chromosome 12 and a subtelomeric probe for 12p on paraffin-embedded tissue sections from 21 dysgerminomas and two gonadoblastomas. Chromosome 12p abnormalities were detected in 81% of dysgerminomas. In all, 57% of cases had only isochromosome 12p and 5% had only 12p overrepresentation. In all, 19% had both isochrome 12p and 12p overrepresentation. Gonadoblastomas were negative for isochromosome 12p or 12p overrepresentation. Chromosome 12p abnormalities are common in dysgerminoma of the ovary. FISH analyses for chromosome 12p abnormalities may be a useful diagnostic adjunct for confirming the diagnosis of dysgerminoma and for distinguishing it from nongerm cell malignancies that enter into the differential diagnosis.