Background: Dysgerminoma is a germ cell tumor of the ovary usually found in young
women. It represents 1% to 2% of all ovarian cancers. The preoperative diagnosis is generally difficult. The surgery
and the pathology study are therefore essential for the diagnosis, and optimal management. The incidence of pregnancy with
dysgerminoma is extremely low. The treatment and management during pregnancy
often jeopardize the materno-fetal prognosis. We report a case of ovarian dysgerminoma in an 18-year-old pregnant
woman. Observation: Patient was an
18-year-old, female with no known past medical history, who presented to the
emergency room at 29 weeks + 3 days pregnancy with dyspnea and a voluminous
uterus (height 42cm). An ultrasound showed an active pregnancy, and a
large vascularized, finely echogenic, multi-partitioned, thick-walled liquid
ovarian tumor. Ca125 was 231.5IU/ml. Ovarian dysgerminoma was suspected. The surgery and the pathology study of the surgical
specimen confirmed the suspected diagnosis. Patient died on postoperative day 8. Conclusion: Ovarian
dysgerminoma is a rare malignant tumor, which must be suspected in case of complex ovarian mass of young women.
When diagnosed during pregnancy, its management jeopardizes the materno-foetal prognosis.
References
[1]
Koshy, M., Vijayananthan, A. and Vadiveloo, V. (2005) Malignant Ovarian Mixed Germ Cell Tumour: A Rare Combination. Biomedical Imaging and Intervention Journal, 1, e10.
[2]
Kurman, R.J., Carcangiu, M.L., Herrington, C.S. and Young, R.H. (2014) WHO Classification of Tumors of Female Reproductive Organs. International Agency for Research on Cancer, Lyon, 4th Edition.
[3]
Yoon, K.L., Chang, Y.Y., Guisera, L. and Dong, C. (2011) Ovarian Dysgerminoma Associated with Pregnancy. Korean Journal of Obstetrics and Gynecology, 54, 218-222.
https://doi.org/10.5468/KJOG.2011.54.4.218
[4]
Lokossou, A., Akpo-Akélé, M.T., Azon-Kouanou, A., Aguidan, L.A., Houngbé, F. and Pérrin, R.X. (2011) Les cancers de l’ovaire en milieu hospitalier à cotonou. Carcinol clin afrique, 10, 29-33.
[5]
Yuichiro, S., Tohru, H., Hidetaka, Y., Ichiro, N., Naoya, K., Jasmina, P., et al. (2017) Dysgerminoma and Pregnancy. Serbian Medical Society.
[6]
Gauza, E.J., Reberti, A.G., Silva, J.C., Pope, L.Z.B., da Rocha dos Santos, J.C. and Quintana, S.M. (2010) Diagnosis of Ovarian Dysgerminoma during Pregnancy. Revista da Associação Médica Brasileira, 56, 517-519.
https://doi.org/10.1590/S0104-42302010000500009
[7]
Chen, Y.Y., Luo, Y., Han, C., Tian, W.Y., et al. (2018) Ovarian Dysgerminoma in Pregnancy: A Case Report and Literature Review. Cancer Biology & Therapy, 19, 649-658.
https://doi.org/10.1080/15384047.2018.1450118
[8]
Kafil, A., Ahmad, S.S., Kumar, A. and Afshan, N. (2011) Dysgerminoma with Pregnancy and Viable Baby: A Case Report. Oman Medical Journal, 26, 198-200.
https://doi.org/10.5001/omj.2011.48
[9]
Goyal, L.D., Kaur, B. and Badyal, R.K. (2019) Malignant Mixed Germ Cell Tumors of the Ovary: A Series of Rare Cases. Journal of Reproduction & Infertility, 20, 231-236.
[10]
Schmitt, C., Lamblin, G., Buenerd, A. and Mellier, G. (2010) Elévation de l’HCG en dehors dun contexte gravidique à propos de deux cas. Journal de gynecologie obstétrique et de biologie de reproduction, 39, 675-678.
https://doi.org/10.1016/j.jgyn.2010.09.001
[11]
Takeshi, I. and Junji, O. (2020) Late Recurrence in Ovarian Dysgerminoma Presenting as a Primary Retroperitoneal Tumor: A Case Report and Review of the Literature. Case Reports in Pathology, 2020, Article ID 4737606.
https://doi.org/10.1155/2020/4737606
[12]
Talerman, A. (2002) Germ Cell Tumors of the Ovary. In: Kurman, R.J., Ed., Blaustein’s Pathology of the Female Genital Tract, Springer-Verlag, New-York, 968-971.
