Ovarian germ cell tumor pathophysiology

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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]

Overveiw

Gross Patholgy

Ovarian germ cell tumor subtype Features on Gross Pathology
Dysgerminoma
  • External surface is smooth and bosselated (knobby)
  • Cut surface it is soft, fleshy and either cream-coloured, gray, pink or tan
Endodermal sinus tumor or yolk sac tumors
  • External surface is smooth and glistening
  • Cut surface is cystic with hemorrhage and necrosis
Embryonal Carcinoma
Teratoma

Teratoma-mature

  • Solid or cystic
  • Cystic content may contain greasy material composed of keratin, hair and teeth
  • Teeth may be found in Rokitansky’s protuberance - a well-defined, nipple-like structure covered with hair

Teratoma-immature

Microscopic Pathology

Ovarian germ cell tumor subtype Features on Histopathological Microscopic Analysis Image
Dysgerminomas
  • Uniform cells that resemble primordial germ cells
  • The stroma contains lymphocytes and about 20% of patients have sarcoid-like granulomas
Micrograph a seminoma, a tumor that is histologically indistinguishable from dysgerminoma.
Endodermal sinus tumor or yolk sac tumors
  • Schiller-Duval bodies - key feature
Micrograph showing the yolk sac component of a mixed germ cell tumor.


Embryonal carcinoma

Main features:[1]

  • Nuclear atypia
  • Nucleoli prominent
  • Necrosis common
  • Nuclei overlap

Other features:

  • Variable architecture:
  • Tubulopapillary
  • Glandular
  • Solid
  • Embryoid bodies - ball of cells in surrounded by empty space on three sides
  • Mitoses common
Embryonal carcinoma
Teratoma

Mature teratoma

  • The sections show ovarian parenchyma with a lesion consisting of benign dermal, gastrointestinal and neural elements
  • The neural elements show focal degenerative changes with macrophages, and giant cells
  • Siderophages are present
Teratoma

References

  1. 1.0 1.1 Abbas, Fausto, Mitchell (2010). Basic Pathology. Elsevier. pp. 696–697. ISBN 978-81-312-1036-9.

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