Ovarian germ cell tumor classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]

Classification

Cellular classification of ovarian germ cell tumors

The following histologic subtypes have been described.

• Dysgerminoma

• Other germ cell tumors:

• Endodermal sinus tumor (rare subtypes are hepatoid and intestinal)
• Embryonal carcinoma
• Polyembryoma
• Choriocarcinoma
• Teratoma:

• Immature
• Mature:

• Solid
• Cystic:

• Dermoid cyst (mature cystic teratoma)
• Dermoid cyst with malignant transformation

• Monodermal and highly specialized:

• Struma ovarii
• Carcinoid
• Others (e.g., malignant neuroectodermal and ependymoma)

• Mixed forms

Germ cell tumours start in the cells that make the eggs (called germ cells) in the ovary.

These tumours account for 2%–3% of all ovarian cancers. 

They usually develop in young women in their teens and 20s.

• Dysgerminoma is rare, but it is the most common malignant ovarian germ cell tumour. They are low-grade tumours (the cancer cells look and act like normal cells and the tumours grow and spread slowly). They may occur in both ovaries.

• Yolk sac tumours (endodermal sinus tumours) are the second most common ovarian germ cell tumour. They are high-grade tumours (the cancer cells don’t look and act like normal cells and the tumours grow and spread quickly). They develop in one ovary and are usually large.

• Embryonal carcinoma is rarely seen in the ovary (it occurs more often in the testicle). It is usually seen as part of a mixed germ cell tumour.

• Polyembryoma is a very rare tumour that is often found as part of a mixed germ cell tumour.

• Choriocarcinoma of the ovary is rare. It is most often found as part of a mixed germ cell tumour.

• Mixed germ cell tumours contain 2 or more different types of germ cell tumour cells. The most common combination is dysgerminoma and yolk sac tumour cells. These tumours are much less common in the ovary than in the testicle. They account for about 8% of ovarian germ cell tumours.

• Immature teratomas are made up of cancer cells that look like cells from a developing embryo. They are uncommon, accounting for about 3% of all teratomas (mature teratomas are benign). Immature teratomas are most often found in girls under the age of 18.

• Small cell carcinoma of the ovary is a very rare, high-grade tumour that is associated with hypercalcemia (higher than normal amounts of calcium in the blood).