Ovary tumor
Germ cell tumors
Dysgerminoma

Authors: Shahrzad Ehdaivand, M.D. (see Authors page)

Revised: 14 September 2018, last major update December 2012

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed search: Ovarian dysgerminoma[title]
Cite this page: Ehdaivand, S. Dysgerminoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumordysgerminoma.html. Accessed November 12th, 2018.
Definition / general
  • Less than 1% of ovarian malignancies
  • Counterpart of testicular seminoma
  • Usually young patients (81% under age 30)
  • 5% associated with gonadal dysgenesis / Swyer syndrome (World J Surg Oncol 2007;5:71), androgen insensitivity or pseudohermaphroditism; rarely associated with hypercalcemia
  • Metastasize to opposite ovary, retroperitoneal nodes and peritoneal cavity
  • Rarely transforms to yolk sac tumor (Mod Pathol 1995;8:881)
  • Survival: 95%
  • Mixture with choriocarcinoma, yolk sac or embryonal carcinoma worsens prognosis
Treatment
  • Surgery and chemotherapy (NOT radiotherapy, although it is effective for seminoma)
Gross description
  • 15% bilateral
  • Solid, nodular, small to huge and gray-pink (resembles cerebral cortex)
  • Hemorrhage and necrosis common, but less prominent than other malignant tumors
Gross images

Images hosted on PathOut server:

Solid, fleshy, lobulated

Cystic degeneration,
necrosis, hemorrhage



Images hosted on other servers:

Various images

Microscopic (histologic) description
  • Nests of tumor cells separated by fibrous stroma with T lymphocytes
  • Large vesicular cells with well defined cell borders, cleared cytoplasm containing glycogen and central nuclei
  • 1+ prominent nucleoli; occasional granulomas
  • May have hCG+ syncytiotrophoblastic cells close to blood vessels or hemorrhagic foci with increased serum hCG
  • May have abortive yolk sac elements with increased serum AFP
  • May be present in wall of mature teratoma; may have pseudotubular or cord-like architecture
  • Early carcinomatous differentiation: 30+ mitoses per 10 high power fields, may worsen prognosis
Microscopic (histologic) images

Images hosted on PathOut server:

Lymphocytes

Cords

Pseudoglandular pattern

Solid tubular pattern

Clear cytoplasm


Dense cytoplasm

Diffuse granulomatous reaction

Syncytiotrophoblastic giant cells (SGCs)

   

Syncytiotrophoblast cells and functioning stroma



Images hosted on other servers:

Left: PLAP; right: CD117



Contributed by Dr. Semir Vranic

15 year old girl

Positive stains
Negative stains
  • CK7, CK20, EMA, HMW keratin, CD30 and vimentin
Molecular / cytogenetics description
Videos


Histopathology Ovary - Dysgerminoma