About the disease

Germ cell tumors are growths that develop in the reproductive cells, located in the ovaries. These cells are also known as egg cells and are responsible for producing female hormones and making eggs ready for fertilization. Ovaries are usually not very big and are almond-sized. They are located on either side of the uterus.

Germ cells tumors can be either benign or malignant, depending on the nature of the growth. They are more common in young women and teenagers but sometimes appear in women who have already gone through the menopause. In both cases, the main manifestation of this disease is vaginal bleeding when the menstrual cycle has not yet begun or had ceased to be active for several years after the menopause.

Dysgerminoma is the most common type of ovarian germ cell tumor. It usually develops in adolescent girls, accounting for approximately 80% of all cases. Most commonly, dysgerminoma develops in just one of the ovaries. In only 10% of cases are both ovaries affected. Although the exact cause of dysgerminoma is unknown, hypercalcemia is believed to be connected. Hypercalcemia is a condition where the level of calcium in the body is too high, causing damage to tissue and organs.

Other links to germ cells tumors of the ovaries include having a genetic predisposition, obesity, alcohol consumption and adverse environmental factors. The good news is that germ cells tumors are very responsive to treatment and the chances for a full recovery are very high, provided it is diagnosed early on.

Symptoms

• Swollen lower abdomen
• Vaginal bleeding not associated with menstrual cycle
• Pain in the lower abdomen
• Weight loss
• Loss of appetite
• Fatigue
• Mood swings

Diagnosis

• During a physical examination, the gynecologist will examine the uterus for signs of unusual growths or lumps. The lower abdomen will also be checked for painful areas, using palpation. A speculum may be used to examine the cervix more closely.
• A laparotomy may be performed in order to take a tissue sample. This is a minimally invasive procedure whereby an incision is made into the side of the abdomen. The tissue sample is then examined under the microscope.
• If a growth such as a cyst or polyp is found, it is removed immediately. A biopsy can also determine whether the tumor is benign or malignant.
• A CT scan creates images that help doctors to examine the ovaries more closely and determine the tumor’s size and dynamics of its growth.

Treatment

• Surgical removal of the growth may also mean the partial or full resection of the affected ovary.
• Chemotherapy kills the malignant cells with powerful drugs that are designed to prevent them from spreading further.
• Radiotherapy irradiates the tumor and shrinks it to the point of complete destruction. One or several courses of radiotherapy can be prescribed.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko