Mixed Germ Cell Tumour of Ovary WTH Chemotherapy Side Effect

Introduction: Mixed germ cell tumour is a very rare type of aggressive cancer, consisting of more than one type of germ cell components. The most common component reported was dysgerminoma, followed by endodermal sinus tumour, teratoma, choriocarcinoma and embryonal carcinoma respectively. This study focuses on the combination of dysgerminoma and endodermal sinus tumour (yolk sac tumour) along with the hearing loss as the side effect of chemotherapy. Clinical Findings: Pain in the lower abdomen (lump is visible and has occupied hypogastrium along with bilateral iliac region extending 2-3 cm above the umbilicus), backache, fever (100.6 °F). Later after the third chemo cycle, it was found that the patient has progressive mild hearing loss. Diagnostic Evaluation: HB= 9.7gm%, TLC= 10300/cumm, PLT= 5,49 lakhs/cumm, CA 125= 909 U/ML. Histopathology Report: Ascitic fluid along with thirteen containers containing right ovarian mass, right ovary with mass, right fallopian tube, bowel deposits as well as residual nodules and pelvic deposits were sent of which, the reports indicated mixed germ cell tumour of the ovary. Therapeutic Intervention: Packed red blood cells transfusion, Pre-chemo and post-chemo hydration, Pre-chemo and post-chemo drugs, BEP Chemotherapy (Bleomycin, Etoposide, Cisplatin). Conclusion: My patient aged 11 years old female was admitted to Gynaecology Ward No – 16, AVBRH on 27/12/2020 for the first cycle of chemotherapy with the complaints of lower abdominal pain, backache and fever. The patient was diagnosed as the case of mixed germ cell tumour, further had mild hearing loss as the side effect of chemotherapy The patient is on chemo and is advised for follow up care once a month.

Characteristics, Management and Survival Rate of Ovarian Germ Cell Tumor

Objective:To determine the prevalence of malignant ovarian germ cell tumour in term of characteristics, management, and 3-year survival rate in Dr. Cipto Mangunkusumo Hospital Jakarta from 2011 to 2013. Methods: This is a cross-sectional study. Secondary data were collected from medical record as well as interviewing patients through phone call or home visit. Results: We collected data from 24 subjects. As many as 54.2% of subjects were between 20 to 40 year old, and 58.3% was single. Around 83.3% of the subjects came with chief complaint of abdominal enlargement. Histopathology finding confirmed dysgerminoma in 50% subjects, mixed ovarian germ cell tumour in 25%, endodermal sinus tumour or yolk sac tumour in 16.7%, and immature teratoma in 8.3%. Half of the cases were found in stage I. The primary therapy was conservative surgical staging and adjuvant chemotherapy.In 2 subjects with dysgerminoma, neoadjuvant chemotherapy (bleomycin, etoposide, cisplatin, and cyclophosphamide-cisplatin regimen) resulted in a good response. The 3-year survival rate was 83.3% in dysgerminoma, 100% in mixed ovarian germ cell tumour, and 50% in immature teratoma. Conclusion: In malignant ovarian germ cell tumour, conservative surgical staging followed by a complete course of chemotherapy is the treatment of choice with 3-year survival rate exceeding 70%. Keywords: dysgerminoma, non-epithelial ovarian tumour,ovarian germ cell tumour, survival Abstrak Tujuan : Mengetahui sebaran meliputi karateristik, penatalaksanaan dan kesintasan 3 tahun pasien tumor ganas sel germinal ovarium di RSCM tahun 2011 – 2013. Metode : Penelitian ini menggunakan studi potong lintang dengan mengambil data sekunder dari rekam medis dan mewawancarai pasien atau keluarga pasien via telepon atau kunjugan rumah. Hasil : Pada penelitian ini, dari 24 subjek penelitian, 54,2% ditemukan pada usia 20-40 tahun dan 58,3% subjek belum menikah. Sebanyak 83,3% datang dengan keluhan perut membesar. Secara histopatologi didapatkan jenis disgeminoma, tumor sel germinal campuran, sinus endodermal (yolk sac) dan teratoma imatur dengan proporsi masing-masing 50%, 25%, 16,7% dan 8,3%, sebagian besar kasus (50%) ditemukan pada stadium I. Conservative surgical staging dan kemoterapi adjuvan tatalaksana pilihan. Terdapat 2 subjek jenis disgerminoma yang diberikan dengan kemoterapi neoadjuvan (regimenbleomycin, etoposide, cisplatin dan cyclophosmide-cisplatin) memberikan respon yang baik. Kesintasan ≥ 3 tahun pada jenis disgerminoma mencapai 83,3%, pada tumor sel germinal campuran 100% dan pada teratoma imatur mencapai 50%. Kesimpulan : Pada tumor ganas sel germinal ovarium conservative surgical staging diikuti kemoterapi lengkap merupakan pilihan terapi dengan kesintasan ≥ 3 tahun mencapai > 70%. Kata kunci : disgerminoma,kesintasan, tumor ovarium non epithelial, tumor sel germinal ovarium.

Imaging of Ovarian Teratomas in Children: A 9-Year Review

Objective Germ cell tumours are the most common ovarian neoplasms in childhood and, of these, teratomas, whether mature or immature, are the most frequently found. Mature teratoma is a benign tumour, whereas the immature type, although also benign, has a more aggressive course, with a propensity to recurrence. A review of the literature revealed that there are some imaging features that may help to differentiate between these 2 types of teratoma, although no systematic comparison has been made. The objective of this study was to review imaging features of ovarian teratomas in children and to assess differentiating imaging features between the mature and immature types of ovarian teratoma. Methods Retrospective analysis of all patients who presented to our institution during a 9-year period (September 1999 to August 2008) with ovarian teratoma as confirmed on histology. Results Forty-one patients with pathologically proven ovarian teratoma were found. The patient ages ranged from 4–18 years at presentation (mean [standard deviation] age, 12.4 ± 3.4 years; median age, 13 years). Thirty patients (73.2%) were found to have mature ovarian teratoma, and 11 (26.8%) had immature teratoma. A component of endodermal sinus tumour was found in one of the immature teratomas. On ultrasonography, the appearance of the immature teratomas was purely solid in 3 (27.3%), mixed solid and cystic in 6 (54.5%), and predominantly cystic in 2 (18%). The mature ovarian teratomas demonstrated a predominantly cystic appearance in 22 (73.3%) and a mixed solid and cystic appearance in 8 (26.6%); there were no cases with a pure solid appearance. The prevalence of the more cystic appearance of the mature type showed significant statistical difference when compared with its prevalence in the immature type ( P = .0008, χ2 test). Other imaging features, such as size, presence of fat, or calcifications, did not show a significant difference between the 2 types of teratoma. Conclusions The predominance of a cystic component and a pure solid component in ovarian teratoma are significant differentiating factors between the mature type and the more aggressive immature type of teratoma.