Clinical analysis of malignant germ cell tumors of the ovary in 9 cases
Objective To analyze the clinical data of patients with malignant germ cell tumors of the ovary(OMMGCT),and to explore their clinical manifestations,pathological features and prognosis.Methods Nine patients with OMMGCT were diagnosed and treated in Henan Provincial People's Hospital from January,2010 to December,2020,and their clinical data were collected,including the age of onset,clinical symptoms,preoperative serum tumor markers,side of the tumor,maximal diameter,nature,pathological stage and type,surgical modality,chemotherapeutic regimen and prognosis.Results Nine patients had an age of onset of 6 to 59 years old,with a median age of 19 years old.The clinical symptoms included abdominal pain in 9 patients,abdominal distension in 3 and fever in 1.The preoperative serum alpha fetoprotein levels were elevated,and the levels of human chorionic gonadotropin,carbohydrate antigen 125,and carbohydrate antigen 19-9 were normal or elevated.The tumors were unilateral in all patients,including 2 cases of OMMGCT on the left side and 7 cases on the right side.The maximal diameter was 5 to 19 cm.The nature of the OMMGCT was solid or cystic solid.The pathological stage was stage Ⅰ in 7 patients and stage Ⅱ in 2.The pathological type contained 2 to 4 components,including 2 components in 7 patients,3 components in 1,and 4 components in 1.Seven patients were found predominantly yolk sac tumor components.All 9 patients underwent surgical treatment,including fertility-preserving surgery in 7 patients and fully staged surgery in 2.All of them received chemotherapy after surgery,including bleomycin+etoposide+cisplatin(BEP)regimen in 6 patients,bleomycin+cisplatin+vincristine regimen in 2,and vincristine+actinomycin+cyclophosphamide regimen in 1.The follow-up after the comprehensive treatment was conducted for 18 to 33 months.One patient in stage Ⅱ underwent a second surgical treatment(hysterectomy+right adnexectomy)2 years after surgery due to recurrence,followed by 6 courses of chemotherapy with the BEP regimen,and she is still alive.The other 8 patients had no recurrence at the end of follow-up.Conclusions OMMGCT occur mostly in young women,with the common clinical symptom of abdominal pain,elevated serum alpha fetoprotein level in different degrees.The mass is usually large,mostly unilateral,in various pathological types,containing 2 to 4 components,mostly yolk cystic tumors.Those with pathological stage of Ⅰ to Ⅱ can choose fertility-preserving surgery followed by chemotherapy(BEP regimen).The short-term prognosis is generally good.
malignant germ cell tumors of the ovaryalpha fetoproteinfertility-preserving surgerychemotherapyBEP regimen
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