Ovarian Germinoma Accelerating the Presentation of Diabetes Mellitus

Abstract

A 12-year-old girl presented to the Children's Emergency Department with symptoms of diabetes mellitus. Glutamic acid decarboxylase autoantibodies and anti-Islet cell antibodies were absent. She was also found to have ovarian dysgerminoma with markedly elevated serum β-human chorionic gonadotropin (β-HCG). With treatment of her ovarian tumor and normalization of the serum β-HCG her insulin therapy was quickly discontinued and metformin started. The ovarian dysgerminoma appeared to have accelerated the presentation of severe diabetes. We hypothesized that the elevated β-HCG and possibly other placental hormones from the germ cell tumor caused her to develop insulin resistance and inadequate β-cell insulin secretory response.

Ovarian dysgerminoma presenting as a pregnancy: case report

“…Ovarian dysgerminomas can produce markedly elevated serum ß-human chorionic gonadotrophin levels 3,4 and hence can give a positive pregnancy test as happened in this case.…”

Ovarian teratoma in a teenager causing ureterohydronephrosis

“…Among the ovarian tumors, dysgerminoma is the most prevalent during puberty. [ 17 , 18 ] In about 10% of the cases, these tumors are bilateral. [ 5 ]…”

“…Among the ovarian tumors, dysgerminoma is the most prevalent during puberty. [17,18] In about 10% of the cases, these tumors are bilateral. [5] Teratomas can be explained through the theory of abnormal differentiation of fetal germ cells that originate from the fetal yolk sac.…”

“…For infants and preschool children, there is a higher incidence of extragonadal teratomas, and in older children and adolescents, there is a higher incidence of gonadal teratomas. Among the ovarian tumors, dysgerminoma is the most prevalent during puberty [17,18] . In about 10% of the cases, these tumors are bilateral [5] …”