Dysgerminoma accounts for less than 1% of ovarian tumors overall. Dysgerminoma usually occurs in adolescence and early adult life; about 5% occur in pre-pubertal children. Dysgerminoma is extremely rare after age 50. Dysgerminoma occurs in both ovaries in 10% of patients and, in a further 10%, there is microscopic tumor in the other ovary.
They are exceptionally associated with hypercalcemia. On gross examination, dysgerminomas present with a smooth, bosselated (knobby) external surface, and is soft, fleshy and either cream-coloured, gray, pink or tan when cut. Microscopic examination typically reveals uniform cells that resemble primordial germ cells. Typically, the stroma contains lymphocytes and about 20% of patients have sarcoid-like granulomas.
Metastases are most often present in the lymph nodes.
Diagnosis
LDH tumour markers is elevated in 95% of the cases.
Dysgerminoma characterized by uniform cells separated by fibrous septa with lymphocytes, H&E stain.
Low-power view of a dysgerminoma infiltrating the colonic wall, H&E stain.
Treatment
Dysgerminomas, like other seminomatous germ cell tumors, are very sensitive to both chemotherapy and radiotherapy. For this reason, with treatment patients' chances of long-term survival, even cure, is excellent.[4] Targeted treatments for dysgerminomas that do not respond to chemotherapy are being evaluated.[4]
