Pregnancy with Ovarian Dysgerminoma : An Unusual Diagnosis

Jain, Manisha

doi:10.9790/0853-1155357

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Dysgerminomas may be asymptomatic or can present with abdominal pain or distension, acute abdomen, or vaginal bleeding [8] . Elevated levels of serum lactate dehydrogenase (LDH) have been noted in patients with dysgerminoma.…”

Section: Discussionmentioning

confidence: 99%

Ovarian Dysgerminoma in Pregnancy

Petrova,

Kubelka-Sabit,

Trajkova

et al. 2023

AMJ

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Dysgerminoma is a very rare germ cell tumor of the ovary. It constitutes about 1% of all germ cell malignancies and accounts for 1-5% of all ovarian malignancies in the first two decades of life. Approximately 80% of cases are reported in patients younger than 30 years of age (mean age: 21 years), whereas 75% of women with dysgerminomas present with stage I of the disease. Ovarian tumors generally remain asymptomatic, until they are discovered due to their large size or related complications.Dysgerminomas can occur in pregnant women. Тhe most commonly used diagnostic methods for ovarian tumors in pregnancy are ultrasound and magnetic resonance, not using radiation for ensuring safety of the fetus. Several factors have influence on treatment decisions such as: gestational week of the pregnancy, patient's expectations, stage of the disease, influence of the diagnostic methods for assessing the stage of the disease on the fetus, as well as the reproductive history of the patient. In stage I of the disease, fertility sparing surgery with unilateral salpingo-oophorectomy can be performed if the patient wants to preserve fertility. No chemotherapy is required for stage I tumors, unless recurrence occurs (9.2% cases).We present a case of dysgerminoma in a pregnant patient, treated with unilateral salpingooophorectomy. After two years of follow-up, the patient remained free of disease.

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Section: Discussionmentioning

confidence: 99%

Ovarian Dysgerminoma in Pregnancy

Petrova,

Kubelka-Sabit,

Trajkova

et al. 2023

AMJ

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“…These tumors may be asymptomatic or can present with pain in abdomen, misdiagnosed as acute appendicitis, ectopic pregnancy, acute abdomen, distension of abdomen with vaginal bleeding. [ 5 ] These tumors can affect conception and if pregnancy occurs, it can lead to maternal-fetal compromise. Increased risk of torsion, incarceration, rupture and hemorrhage can occur during pregnancy and vaginal delivery.…”

Section: Discussionmentioning

confidence: 99%

Ovarian dysgerminoma in pregnancy

et al. 2021

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Rationale: Although dysgerminomas are relatively uncommon among all ovarian neoplasms, representing for only about 2%, they account for 32.8 percent of malignant ovarian germ cell tumors. Their association with pregnancy is extremely rare; due to the low frequency of occurrence, there are few recommendations regarding pregnancy management; therefore, it is important to discuss and summarize the treatment strategy. Patient concerns: We present the case of a 25 years patient, gestation 1, para 1, who was hospitalized in the clinic at 38/39 weeks of gestation at the beginning of labor. Following the ultrasound examination, a hypoechogenic lesion on the uterine fundus was found, suggestive of subterranean fibroid. After caesarean section, right adnexectomy was performed; the histopathological examination revealed, unexpectedly, the diagnosis of dysgerminoma. Diagnoses: Dysgerminoma as associated with pregnancy. Interventions: Birth by Caesarean section and right adnexectomy. No other medical complications occurred. Outcomes: The histopathological and immunohistochemical examinations were consistent with the pure dysgerminoma. Oncology was staged AI, with the monitoring of markers and abdominal and pelvic magnetic resonance imaging at 3, 6, 9, and 12 months. Lessons: Dysgerminoma is the most common ovarian malignancy associated with pregnancy with a good fetal maternal outcome. If these tumors are discovered accidentally during caesarean section, tumor markers and magnetic resonance imaging scanning should be done postoperatively to plan optimal treatment.

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“…The second trimester of pregnancy is ‘safety period’ or the best moment for performing surgery intervention of adnexal mass because at this period the dependency of hormonal secretion from corpus luteum during pregnancy is decreased so that the risk of spontaneous abortion is low [2], [5], [11]. There was a tocolytic administration consensus, the tocolytic agent can be given before or immediately after surgery and to be continued 24 to 48-hour post-surgery [12]. Routine tocolytic administration still controversial, but the administration can be considered if there are signs of preterm labour [7], [13].…”

Section: Discussionmentioning

confidence: 99%

Ovarian Cancer Immature Teratoma Type in Pregnancy: Management and Feto-Maternal Outcomes

Luh¹,

Nyoman²,

Aag³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Immature teratoma is malignant ovarian germ cell tumours (MOGCTs). The case in pregnancy is very rare which less than 1% of all ovarian teratoma cases. The aim is to reach optimal and comprehensive management for immature ovarian teratoma in pregnancy to gain the healthiest maternal and fetal outcomes. CASE PRESENTATION: Thirty-one years old female G2P1A0, 8 weeks 1-day pregnancy, with left ovarian solid tumour 15 x 15 x 15 cm in size. At gestational age (GA) of 19 weeks 5 days, the size of the tumour was increasing rapidly to 30 x 30 x 30 cm. Alfa-fetoprotein raised to 699.9 IU/mL and LDH 579 U/L. The patient had gone primary conservative left oophorectomy, omentectomy, and ascites fluid cytology with histopathological conclusion grade II immature teratoma of left ovary containing the immature neuroepithelial and fat component: magnetic resonance imaging (MRI) at 25 weeks 3 days GA, no spreading. Amniocentesis performed at 27 weeks 2 days GA, the fetus had normal 46 chromosomes and sex XX without major structural abnormality. The patient had BEP chemotherapy start at 27 weeks 2 days GA. Patient in labour at 40 weeks 2 days GA. The female baby had spontaneous delivery with 2700 grams in body weight without congenital abnormality. Complete surgical staging performed at 58th days postpartum and histopathological result there was no malignant cell anymore, but post-chemotherapy ovarian atrophy feature had found on the contralateral ovary. The patient showed psychosocial problem including post-chemotherapy depression and premature ovarian failure (POF). Immunohistochemistry (IHC) ER and PR of teratoma tissue showed immature component had ER (-) and PR (+). Follow up of the baby was in good condition. CONCLUSION: BEP chemotherapy become regimen choice for this case with fetal outcomes was good, but there was a POF sign on the mother. Survival of patient on this case is 62%, free recurrence survival post-BEP 84% and progressivity post complete surgical staging 8% without delay the chemotherapy.

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Pregnancy with Ovarian Dysgerminoma : An Unusual Diagnosis

Cited by 5 publications

References 19 publications

Ovarian Dysgerminoma in Pregnancy

Ovarian Dysgerminoma in Pregnancy

Ovarian dysgerminoma in pregnancy

Ovarian Cancer Immature Teratoma Type in Pregnancy: Management and Feto-Maternal Outcomes

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