Malignant germ cell tumors of the ovary: A study of 20 cases

In a study of 20 patients diagnosed with malignant ovarian germ cell tumors between 1961 and 1993, clinical and pathologic findings were evaluated. Of the 20 patients, seven (35%) had dysgerminoma, two (10%) endodermal sinus tumor, three (15%) malignant teratoma, one (5%) malignant struma ovarii, one (5%) primary ovarian carcinoid, two (10%) benign teratoma with malignant transformation, and four (20%) combination germ cell tumor. Twelve patients (60%) had stage IA, five (25%) stage IC, and three (15%) stage IIIC. Twelve patients (60%) underwent conservative surgery and eight (40%) had at least bilateral salpingo‐oophorectomy. At follow‐up, 18 patients (90%) were alive free of disease, one (5%) had died of disease, and one (5%) had died of intercurrent disease. The actuarial 5‐year survival rate was 93.3%. It is concluded that for young women who wish to preserve child‐bearing capacity, regardless of the stage of the tumor, fertility‐preserving surgery with complete surgical staging followed, if necessary by cisplatin‐based combination chemotherapy is an appropriate and definitive treatment in the absence of involvement of the contralateral ovary and uterus. For patients in whom child‐bearing capacity is not an issue, surgery should include total abdominal hysterectomy and bilateral salpingooophorectomy with complete staging, followed if necessary by chemotherapy.