Ovarian germ cell tumor pathophysiology

	Ovarian germ cell tumor Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Epidemiology and Demographics
Risk Factors
Screening
Differentiating Ovarian germ cell tumor from other Diseases
Natural History, Complications and Prognosis
Diagnosis
Staging
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Surgery
Chemotherapy
Radiotherapy
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Ovarian germ cell tumor pathophysiology On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Ovarian germ cell tumor pathophysiology All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Ovarian germ cell tumor pathophysiology
CDC on Ovarian germ cell tumor pathophysiology
Ovarian germ cell tumor pathophysiology in the news
Blogs on Ovarian germ cell tumor pathophysiology
Directions to Hospitals Treating Ovarian germ cell tumor
Risk calculators and risk factors for Ovarian germ cell tumor pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Monalisa Dmello, M.B,B.S., M.D. [3]

Overveiw

The pathophysiology of ovarian germ cell tumors depends on the histological subtype. However, their origin is the primordial germ cells that transformed pathologically in different stages of development.

Pathophysiology

Physiology

The normal physiology of [name of process] can be understood as follows:

Pathogenesis

It is understood that ovarian germ cell tumors are the result of the pathologic transformation of primordial germ cells during different stages of the development.^[1]^[2]

Germ cell

Pathogenesis

Malignant transformation

Mature teratoma

Tumors esxpressing transcription factors of pluripotency

Tumors with primitive embryonic ectoderm, mesoderm, and/or endoderm differentiation

Tumors with extraembroyonic differentiation

Dysgerminoma/Embryonal carcinoma

Immature teratoma

Yolk sac tumor/Choriocarcinoma

Mature teratoma

Mature teratomas are benign tumors originating from pathologic development of primordial germ cells.^[3]
It originates from a single germ cell tumor after the first phase of meiosis.^[4]
These tumors contain the well-differentiated component of three germ layers.^[3]
Their usual location is the embryonic fusion line overhead and neck, mediastinum, a and presacral area and tend to present at a greater extent in the midline.

Dysgerminoma

Dysgerminoma arises from primordial germ cells, which are gonadal cells that are normally involved in the gametogenesis.^[1]
The majority of dysgerminomas in women present in the stage 1A.^[5]
Bilateral invovlement occurs in 10% to 15% of the cases.
In < 15% of the affected cases, elements of other germ cell tumors can also be found.^[6]

Yolk sac tumor

These tumors develop from differentiation of primitive germ cells in the direction of yolk sac or vitelline structures.^[7]
They tend to grow very rapidly.^[8]
Bilateral involvement occurs in less than 5% of the cases.
In 10% of the cases, the contralateral ovary carries a dermoid cyst.
In 40% of cases, they are accompanied by other types of germ cell tumors.^[9]

Genetics

Ovarian germ cell teratomas may be associated with cytogenetic abnormalities.
Immature teratomas may be associated with chromosomal changes such as:^[10]
- Gain of all or parts of
  - 1p
  - 16p
  - 19
  - 22q
Dysgerminomas may be associated with gain or loss of complete or partial chromosomal materials such as:^[10]
- Gain of:
  - 1p
  - 6p
  - 12p
  - 12q
  - 15q
  - 20q
  - 21q
  - 22q
  - Whole of chromosome 7
  - Whole of chromosome 8
  - Whole of chromosome 17
  - Whole of chromosome 19
- Losses from 13q
Yolk sac tumor is associated with gaining of the 12p chromosome in 75% of the cases.^[10]
- It may also be associated with chromosomal changes such as:
  - Gain of 1q

Associated Conditions

Conditions associated with mature teratoma include:

Anti-NMDA receptor encephalitis (although very rarely)^[11]
Rarely, they contain pituitary cells capable of prolactin production and is associated with prolactinoma.^[12]

Gross Pathology

Ovarian germ cell tumor subtype	Features on Gross Pathology
Dysgerminonma	Unilateral (bilateral in 10% to 20% of the cases)^[13] more common on the right side Solid, white or grayish-withe tumors
Embryonal Carcinoma	Unilateral, large mass, averaging 17 cm ^[8] Smooth outer surface Extensive area of necrosis and hemorrhage
Endodermal sinus tumor or yolk sac tumors	Mixed solid and cystic component^[8] The solid portion is soft with grey to yellow color and areas of necrosis and/or hemorrhage The cystic portion is in between solid components and results in a meshlike/honeycomb appearance Unilateral and commonly affects the right ovary^[9]
Mixed germ cell tumors	Composed of more than one germ cell tumor element^[8] Main components are: Dysgerminoma Teratoma Yolk sac tumor Other germ cell tumors may be present
Polyembryoma	Large, unilateral tumor with microcystic surface^[14] Bulky appearance Soft and reddish-brown color hemorrhage in cut surfaces
Teratoma	Teratoma-mature The majority are 5 to 10 cm in diameter.^[15] Unilocular in the majority of cases (88%) Predominantly cystic Cystic content may contain sebaceous material that is semi-liquid in room temperature Teeth may be found in Rokitansky’s protuberance - a well-defined, nipple-like structure covered with hair Teratoma-immature Usually appear larger than mature teratomas^[16] May be solid or with a prominent solid element Cystic cavities may be filled with serous or mucinous or fatty-sebaceous fluid. Ths capsular component may not always be well-defined Teratoma-monodermal Struma ovarii: amber-colored thyroid tissue with areas of hemorrhage, necrosis, and fibrosis ^[16] Carcinoid tumor: a solid mass

Microscopic Pathology

Ovarian germ cell tumor subtype	Features on Histopathological Microscopic Analysis	Image
Dysgerminomas	large, uniform, clear cells arranged in sheets ^[8] Uniform cells has an "fried egg appearance"(large cytoplasm and small nucleus) that resemble primordial germ cells The stroma contains lymphocytes and septa like components.	Micrograph a seminoma, a tumor that is histologically indistinguishable from dysgerminoma.
Embryonal carcinoma	Pseudoglandular pattern of primitive cells ^[8] Nuclei are: Large Croweded Pleomorphic With prominent nucleoli	Embryonal carcinoma
Endodermal sinus tumor or yolk sac tumors	Schiller-Duval bodies (resemble renal glomeruli) - key feature ^[8]	Micrograph showing the yolk sac component of a mixed germ cell tumor.
Polyemryoma	Usually as a part of mixed germ cell tumor^[8] Contains small embryo-like bodies with central germ disks Germ disk cavity has two part: Embryonal carcinoma epithelia Two cavities: Dorsal cavity that resembles the amniotic cavity Ventral cavity that resembles the yolk sac cavity
Teratoma	Mature teratoma The sections show ovarian parenchyma with a lesion consisting of benign dermal, gastrointestinal, and neural elements.^[17] The neural elements show focal degenerative changes with macrophages and giant cells Siderophages are present. In general, mature teratoma usually appears as a well-established organization of tissues mimicking the relationship observed in normal organs such as:^[18] respiratory epithelial layer surrounded by smooth muscle and cartilage Usually, there is scant mitosis in the tumor cells usually limited to the normal proliferative zone of the body part that they produce. No cytologic atypia is present. Different type of tissues may be observed in the mature teratomas of the ovary such as: Choroid plexus Thyroid tissues Pituitary tissues, although not commonly.^[12] Rarely, they produce prolactin and is associated with prolactinoma. Immature teratoma Tissues originating from the two or three embroyanl layers are present.^[8] There is a mixture of mature and immature tissue (primitive cells). The presence of primitive elements is necessary to make the diagnosis.	Teratoma

Immunohistochemistry

Dysgerminoma

Dysgerminoma is positive for:^[19]
- OCT4 (this marker is a key diagnostic factor for the diagnosis of dysgerminoma)

Embryonal carcinoma

These tumors are positive for:^[8]
- CD30
- EMA
- OCT3/4

Endodermal sinus tumor

Yolk sac tumors are positive for:^[19]^[20]
- AFP
  - Absence of AFP does not exclude the diagnosis.
- Cytokeratin (AE1/AE3)
- Placental-like alkaline phosphatase in 50% of the individuals.
- SALL4 (nuclear) in > 90% of the cases.
- GPC3

Non-gestational chriocarcinoma

These tumors stain for keratins strongly.^[21]
- AE1
- AE3
- CAM5
Trophoblastic cells are positive for CD10.
Tumor may be positive for:
- GATA3 (nuclear) in 80% of the cases^[22]
- SALL4 (nuclear) in 70% of the cases^[23]
- PLAP and EMA in 50% of the cases^[24]

Polyembryoma

Embryoid body of the tumor may be positive for Glypican3.^[25]

Teratoma

Usually, teratomas are diagnosed histologically and routine use of immunohistochemistry is not needed. However it may be needed in the diagnosis of immature and monodermal types.
Neuronal elements of mature or immature teratomas are positive for:^[26]
- Glial fibrillary acidic protein (GFAP)
- neuron specific enolase (NSE)
- S-100
Monodermal teratoma^[16]
- Carcionid tumor may be positive for serotonin and hormonal peptides.

References

↑ ^1.0 ^1.1 El-Maarri, Osman; Rijlaarsdam, Martin A.; Tax, David M. J.; Gillis, Ad J. M.; Dorssers, Lambert C. J.; Koestler, Devin C.; de Ridder, Jeroen; Looijenga, Leendert H. J. (2015). "Genome Wide DNA Methylation Profiles Provide Clues to the Origin and Pathogenesis of Germ Cell Tumors". PLOS ONE. 10 (4): e0122146. doi:10.1371/journal.pone.0122146. ISSN 1932-6203.
↑ Carcangiu, M. L. (2014). WHO Classification of Tumours of Female Reproductive Organs. Lyon: International Agency for Research on Cancer. ISBN 978-92-832-4487-5.
↑ ^3.0 ^3.1 Vural, F.; Vural, B.; Paksoy, N. (2015). "Vaginal teratoma: A case report and review of the literature". Journal of Obstetrics and Gynaecology. 35 (7): 757–758. doi:10.3109/01443615.2015.1004525. ISSN 0144-3615.
↑ Linder, David; McCaw, Barbara Kaiser; Hecht, Frederick (1975). "Parthenogenic Origin of Benign Ovarian Teratomas". New England Journal of Medicine. 292 (2): 63–66. doi:10.1056/NEJM197501092920202. ISSN 0028-4793.
↑ A L Husaini H, Soudy H, El Din Darwish A, Ahmed M, Eltigani A, A L Mubarak M, Sabaa AA, Edesa W, A L-Tweigeri T, Al-Badawi IA (December 2012). "Pure dysgerminoma of the ovary: a single institutional experience of 65 patients". Med. Oncol. 29 (4): 2944–8. doi:10.1007/s12032-012-0194-z. PMID 22407668. Vancouver style error: missing comma (help)
↑ Gordon A, Lipton D, Woodruff JD (October 1981). "Dysgerminoma: a review of 158 cases from the Emil Novak Ovarian Tumor Registry". Obstet Gynecol. 58 (4): 497–504. PMID 7279343.
↑ Young, Robert H. (2014). "The Yolk Sac Tumor". International Journal of Surgical Pathology. 22 (8): 677–687. doi:10.1177/1066896914558265. ISSN 1066-8969.
↑ ^8.0 ^8.1 ^8.2 ^8.3 ^8.4 ^8.5 ^8.6 ^8.7 ^8.8 ^8.9 Shaaban, Akram M.; Rezvani, Maryam; Elsayes, Khaled M.; Baskin, Henry; Mourad, Amr; Foster, Bryan R.; Jarboe, Elke A.; Menias, Christine O. (2014). "Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features". RadioGraphics. 34 (3): 777–801. doi:10.1148/rg.343130067. ISSN 0271-5333.
↑ ^9.0 ^9.1 Kojimahara, Takanobu; Nakahara, Kenji; Takano, Tadao; Yaegashi, Nobuo; Nishiyama, Hiroshi; Fujimori, Keiya; Sato, Naoki; Terada, Yukihiro; Tase, Toru; Yokoyama, Yoshihito; Mizunuma, Hideki; Shoji, Tadahiro; Sugiyama, Toru; Kurachi, Hirohisa (2013). "Yolk Sac Tumor of the Ovary: A Retrospective Multicenter Study of 33 Japanese Women by Tohoku Gynecologic Cancer Unit (TGCU)". The Tohoku Journal of Experimental Medicine. 230 (4): 211–217. doi:10.1620/tjem.230.211. ISSN 1349-3329.
↑ ^10.0 ^10.1 ^10.2 Kraggerud SM, Szymanska J, Abeler VM, Kaern J, Eknaes M, Heim S, Teixeira MR, Tropé CG, Peltomäki P, Lothe RA (June 2000). "DNA copy number changes in malignant ovarian germ cell tumors". Cancer Res. 60 (11): 3025–30. PMID 10850452.
↑ Dalmau, Josep; Gleichman, Amy J; Hughes, Ethan G; Rossi, Jeffrey E; Peng, Xiaoyu; Lai, Meizan; Dessain, Scott K; Rosenfeld, Myrna R; Balice-Gordon, Rita; Lynch, David R (2008). "Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies". The Lancet Neurology. 7 (12): 1091–1098. doi:10.1016/S1474-4422(08)70224-2. ISSN 1474-4422.
↑ ^12.0 ^12.1 Kallenberg, GA; Pesce, CM; Norman, B; Ratner, RE; Silverberg, SG (1991). "Ectopic hyperprolactinemia resulting from an ovarian teratoma". International Journal of Gynecology & Obstetrics. 34 (2): 194–195. doi:10.1016/0020-7292(91)90266-8. ISSN 0020-7292.
↑ Chen, Vivien W.; Ruiz, Bernardo; Killeen, Jeffrey L.; Cot�, Timothy R.; Wu, Xiao Cheng; Correa, Catherine N.; Howe, Holly L. (2003). "Pathology and classification of ovarian tumors". Cancer. 97 (S10): 2631–2642. doi:10.1002/cncr.11345. ISSN 0008-543X. replacement character in |last4= at position 4 (help)
↑ Oliva, Esther; Young, Robert H. (2014). "Germ cell tumours of the ovary: selected topics". Diagnostic Histopathology. 20 (9): 364–375. doi:10.1016/j.mpdhp.2014.07.003. ISSN 1756-2317.
↑ Yayla Abide, Çiğdem; Bostancı Ergen, Evrim (2018). "Retrospective analysis of mature cystic teratomas in a single center and review of the literature". Journal of Turkish Society of Obstetric and Gynecology. 15 (2): 95–98. doi:10.4274/tjod.86244. ISSN 1307-699X.
↑ ^16.0 ^16.1 ^16.2 Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). "Ovarian Teratomas: Tumor Types and Imaging Characteristics". RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.
↑ Mature teratoma. http://librepathology.org/wiki/index.php/Teratoma#Mature_teratoma. URL Accessed on November 12, 2015
↑ Ulbright TM (February 2005). "Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues". Mod. Pathol. 18 Suppl 2: S61–79. doi:10.1038/modpathol.3800310. PMID 15761467.
↑ ^19.0 ^19.1 Pectasides, D.; Pectasides, E.; Kassanos, D. (2008). "Germ cell tumors of the ovary". Cancer Treatment Reviews. 34 (5): 427–441. doi:10.1016/j.ctrv.2008.02.002. ISSN 0305-7372.
↑ Cao, Dengfeng; Guo, Shuangping; Allan, Robert W.; Molberg, Kyle H.; Peng, Yan (2009). "SALL4 Is a Novel Sensitive and Specific Marker of Ovarian Primitive Germ Cell Tumors and Is Particularly Useful in Distinguishing Yolk Sac Tumor From Clear Cell Carcinoma". The American Journal of Surgical Pathology. 33 (6): 894–904. doi:10.1097/PAS.0b013e318198177d. ISSN 0147-5185.
↑ Ordi J, Romagosa C, Tavassoli FA, Nogales F, Palacin A, Condom E, Torné A, Cardesa A (February 2003). "CD10 expression in epithelial tissues and tumors of the gynecologic tract: a useful marker in the diagnosis of mesonephric, trophoblastic, and clear cell tumors". Am. J. Surg. Pathol. 27 (2): 178–86. PMID 12548163.
↑ Banet, Natalie; Gown, Allen M.; Shih, Ie-Ming; Kay Li, Qing; Roden, Richard B.S.; Nucci, Marisa R.; Cheng, Liang; Przybycin, Christopher G.; Nasseri-Nik, Niloofar; Wu, Lee-Shu-Fune; Netto, George J.; Ronnett, Brigitte M.; Vang, Russell (2015). "GATA-3 Expression in Trophoblastic Tissues". The American Journal of Surgical Pathology. 39 (1): 101–108. doi:10.1097/PAS.0000000000000315. ISSN 0147-5185.
↑ Miettinen, Markku; Wang, Zengfeng; McCue, Peter A.; Sarlomo-Rikala, Maarit; Rys, Janusz; Biernat, Wojciech; Lasota, Jerzy; Lee, Yi-Shan (2014). "SALL4 Expression in Germ Cell and Non–Germ Cell Tumors". The American Journal of Surgical Pathology. 38 (3): 410–420. doi:10.1097/PAS.0000000000000116. ISSN 0147-5185.
↑ Niehans GA, Manivel JC, Copland GT, Scheithauer BW, Wick MR (September 1988). "Immunohistochemistry of germ cell and trophoblastic neoplasms". Cancer. 62 (6): 1113–23. PMID 2457424.
↑ Preda, Ovidiu; Nicolae, Alina; Aneiros-Fernández, José; Borda, Angela; Nogales, Francisco F (2011). "Glypican 3 is a sensitive, but not a specific, marker for the diagnosis of yolk sac tumours". Histopathology. 58 (2): 312–314. doi:10.1111/j.1365-2559.2010.03735.x. ISSN 0309-0167.
↑ Takayama, Yoshiyasu; Matsumura, Nozomi; Nobusawa, Sumihito; Ikota, Hayato; Minegishi, Takashi; Yokoo, Hideaki (2015). "Immunophenotypic features of immaturity of neural elements in ovarian teratoma". Virchows Archiv. 468 (3): 337–343. doi:10.1007/s00428-015-1891-8. ISSN 0945-6317.

Template:WikiDoc Sources

[El-MaarriRijlaarsdam2015-1] 1.0 ^1.1 El-Maarri, Osman; Rijlaarsdam, Martin A.; Tax, David M. J.; Gillis, Ad J. M.; Dorssers, Lambert C. J.; Koestler, Devin C.; de Ridder, Jeroen; Looijenga, Leendert H. J. (2015). "Genome Wide DNA Methylation Profiles Provide Clues to the Origin and Pathogenesis of Germ Cell Tumors". PLOS ONE. 10 (4): e0122146. doi:10.1371/journal.pone.0122146. ISSN 1932-6203.

[2] Carcangiu, M. L. (2014). WHO Classification of Tumours of Female Reproductive Organs. Lyon: International Agency for Research on Cancer. ISBN 978-92-832-4487-5.

[VuralVural2015-3] 3.0 ^3.1 Vural, F.; Vural, B.; Paksoy, N. (2015). "Vaginal teratoma: A case report and review of the literature". Journal of Obstetrics and Gynaecology. 35 (7): 757–758. doi:10.3109/01443615.2015.1004525. ISSN 0144-3615.

[LinderMcCaw1975-4] Linder, David; McCaw, Barbara Kaiser; Hecht, Frederick (1975). "Parthenogenic Origin of Benign Ovarian Teratomas". New England Journal of Medicine. 292 (2): 63–66. doi:10.1056/NEJM197501092920202. ISSN 0028-4793.

[pmid22407668-5] A L Husaini H, Soudy H, El Din Darwish A, Ahmed M, Eltigani A, A L Mubarak M, Sabaa AA, Edesa W, A L-Tweigeri T, Al-Badawi IA (December 2012). "Pure dysgerminoma of the ovary: a single institutional experience of 65 patients". Med. Oncol. 29 (4): 2944–8. doi:10.1007/s12032-012-0194-z. PMID 22407668. Vancouver style error: missing comma (help)

[pmid7279343-6] Gordon A, Lipton D, Woodruff JD (October 1981). "Dysgerminoma: a review of 158 cases from the Emil Novak Ovarian Tumor Registry". Obstet Gynecol. 58 (4): 497–504. PMID 7279343.

[Young2014-7] Young, Robert H. (2014). "The Yolk Sac Tumor". International Journal of Surgical Pathology. 22 (8): 677–687. doi:10.1177/1066896914558265. ISSN 1066-8969.

[ShaabanRezvani2014-8] 8.0 ^8.1 ^8.2 ^8.3 ^8.4 ^8.5 ^8.6 ^8.7 ^8.8 ^8.9 Shaaban, Akram M.; Rezvani, Maryam; Elsayes, Khaled M.; Baskin, Henry; Mourad, Amr; Foster, Bryan R.; Jarboe, Elke A.; Menias, Christine O. (2014). "Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features". RadioGraphics. 34 (3): 777–801. doi:10.1148/rg.343130067. ISSN 0271-5333.

[KojimaharaNakahara2013-9] 9.0 ^9.1 Kojimahara, Takanobu; Nakahara, Kenji; Takano, Tadao; Yaegashi, Nobuo; Nishiyama, Hiroshi; Fujimori, Keiya; Sato, Naoki; Terada, Yukihiro; Tase, Toru; Yokoyama, Yoshihito; Mizunuma, Hideki; Shoji, Tadahiro; Sugiyama, Toru; Kurachi, Hirohisa (2013). "Yolk Sac Tumor of the Ovary: A Retrospective Multicenter Study of 33 Japanese Women by Tohoku Gynecologic Cancer Unit (TGCU)". The Tohoku Journal of Experimental Medicine. 230 (4): 211–217. doi:10.1620/tjem.230.211. ISSN 1349-3329.

[pmid10850452-10] 10.0 ^10.1 ^10.2 Kraggerud SM, Szymanska J, Abeler VM, Kaern J, Eknaes M, Heim S, Teixeira MR, Tropé CG, Peltomäki P, Lothe RA (June 2000). "DNA copy number changes in malignant ovarian germ cell tumors". Cancer Res. 60 (11): 3025–30. PMID 10850452.

[DalmauGleichman2008-11] Dalmau, Josep; Gleichman, Amy J; Hughes, Ethan G; Rossi, Jeffrey E; Peng, Xiaoyu; Lai, Meizan; Dessain, Scott K; Rosenfeld, Myrna R; Balice-Gordon, Rita; Lynch, David R (2008). "Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies". The Lancet Neurology. 7 (12): 1091–1098. doi:10.1016/S1474-4422(08)70224-2. ISSN 1474-4422.

[KallenbergPesce1991-12] 12.0 ^12.1 Kallenberg, GA; Pesce, CM; Norman, B; Ratner, RE; Silverberg, SG (1991). "Ectopic hyperprolactinemia resulting from an ovarian teratoma". International Journal of Gynecology & Obstetrics. 34 (2): 194–195. doi:10.1016/0020-7292(91)90266-8. ISSN 0020-7292.

[ChenRuiz2003-13] Chen, Vivien W.; Ruiz, Bernardo; Killeen, Jeffrey L.; Cot�, Timothy R.; Wu, Xiao Cheng; Correa, Catherine N.; Howe, Holly L. (2003). "Pathology and classification of ovarian tumors". Cancer. 97 (S10): 2631–2642. doi:10.1002/cncr.11345. ISSN 0008-543X. replacement character in |last4= at position 4 (help)

[OlivaYoung2014-14] Oliva, Esther; Young, Robert H. (2014). "Germ cell tumours of the ovary: selected topics". Diagnostic Histopathology. 20 (9): 364–375. doi:10.1016/j.mpdhp.2014.07.003. ISSN 1756-2317.

[Yayla_AbideBostancı_Ergen2018-15] Yayla Abide, Çiğdem; Bostancı Ergen, Evrim (2018). "Retrospective analysis of mature cystic teratomas in a single center and review of the literature". Journal of Turkish Society of Obstetric and Gynecology. 15 (2): 95–98. doi:10.4274/tjod.86244. ISSN 1307-699X.

[OutwaterSiegelman2001-16] 16.0 ^16.1 ^16.2 Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). "Ovarian Teratomas: Tumor Types and Imaging Characteristics". RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.

[wpp-17] Mature teratoma. http://librepathology.org/wiki/index.php/Teratoma#Mature_teratoma. URL Accessed on November 12, 2015

[pmid15761467-18] Ulbright TM (February 2005). "Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues". Mod. Pathol. 18 Suppl 2: S61–79. doi:10.1038/modpathol.3800310. PMID 15761467.

[PectasidesPectasides2008-19] 19.0 ^19.1 Pectasides, D.; Pectasides, E.; Kassanos, D. (2008). "Germ cell tumors of the ovary". Cancer Treatment Reviews. 34 (5): 427–441. doi:10.1016/j.ctrv.2008.02.002. ISSN 0305-7372.

[CaoGuo2009-20] Cao, Dengfeng; Guo, Shuangping; Allan, Robert W.; Molberg, Kyle H.; Peng, Yan (2009). "SALL4 Is a Novel Sensitive and Specific Marker of Ovarian Primitive Germ Cell Tumors and Is Particularly Useful in Distinguishing Yolk Sac Tumor From Clear Cell Carcinoma". The American Journal of Surgical Pathology. 33 (6): 894–904. doi:10.1097/PAS.0b013e318198177d. ISSN 0147-5185.

[pmid12548163-21] Ordi J, Romagosa C, Tavassoli FA, Nogales F, Palacin A, Condom E, Torné A, Cardesa A (February 2003). "CD10 expression in epithelial tissues and tumors of the gynecologic tract: a useful marker in the diagnosis of mesonephric, trophoblastic, and clear cell tumors". Am. J. Surg. Pathol. 27 (2): 178–86. PMID 12548163.

[BanetGown2015-22] Banet, Natalie; Gown, Allen M.; Shih, Ie-Ming; Kay Li, Qing; Roden, Richard B.S.; Nucci, Marisa R.; Cheng, Liang; Przybycin, Christopher G.; Nasseri-Nik, Niloofar; Wu, Lee-Shu-Fune; Netto, George J.; Ronnett, Brigitte M.; Vang, Russell (2015). "GATA-3 Expression in Trophoblastic Tissues". The American Journal of Surgical Pathology. 39 (1): 101–108. doi:10.1097/PAS.0000000000000315. ISSN 0147-5185.

[MiettinenWang2014-23] Miettinen, Markku; Wang, Zengfeng; McCue, Peter A.; Sarlomo-Rikala, Maarit; Rys, Janusz; Biernat, Wojciech; Lasota, Jerzy; Lee, Yi-Shan (2014). "SALL4 Expression in Germ Cell and Non–Germ Cell Tumors". The American Journal of Surgical Pathology. 38 (3): 410–420. doi:10.1097/PAS.0000000000000116. ISSN 0147-5185.

[pmid2457424-24] Niehans GA, Manivel JC, Copland GT, Scheithauer BW, Wick MR (September 1988). "Immunohistochemistry of germ cell and trophoblastic neoplasms". Cancer. 62 (6): 1113–23. PMID 2457424.

[PredaNicolae2011-25] Preda, Ovidiu; Nicolae, Alina; Aneiros-Fernández, José; Borda, Angela; Nogales, Francisco F (2011). "Glypican 3 is a sensitive, but not a specific, marker for the diagnosis of yolk sac tumours". Histopathology. 58 (2): 312–314. doi:10.1111/j.1365-2559.2010.03735.x. ISSN 0309-0167.

[TakayamaMatsumura2015-26] Takayama, Yoshiyasu; Matsumura, Nozomi; Nobusawa, Sumihito; Ikota, Hayato; Minegishi, Takashi; Yokoo, Hideaki (2015). "Immunophenotypic features of immaturity of neural elements in ovarian teratoma". Virchows Archiv. 468 (3): 337–343. doi:10.1007/s00428-015-1891-8. ISSN 0945-6317.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

Ovarian germ cell tumor pathophysiology

Overveiw

Pathophysiology

Physiology

Pathogenesis

Mature teratoma

Dysgerminoma

Yolk sac tumor

Genetics

Associated Conditions

Gross Pathology

Microscopic Pathology

Immunohistochemistry

Dysgerminoma

Embryonal carcinoma

Endodermal sinus tumor

Non-gestational chriocarcinoma

Polyembryoma

Teratoma

References

Navigation menu