BACKGROUND Malignant ovarian germ cell tumors(MOGCT)are rare and frequently occur in women of young and reproductive age and the oncologic and reproductive outcomes after fertility-sparing surgery(FSS)for this disease...BACKGROUND Malignant ovarian germ cell tumors(MOGCT)are rare and frequently occur in women of young and reproductive age and the oncologic and reproductive outcomes after fertility-sparing surgery(FSS)for this disease are still limited.AIM To evaluate the oncology and reproductive outcomes of MOGCT patients who underwent FSS.METHODS All MOGCT patients who underwent FSS defined as the operation with a preserved uterus and at least one side of the ovary at our institute between January 2005 and December 2020 were retrospectively reviewed.RESULTS Sixty-two patients were recruited for this study.The median age was 22 years old and over 77%were nulliparous.The three most common histology findings were immature teratoma(32.2%),dysgerminoma(24.2%),and yolk sac tumor(24.2%).The distribution of stage was as follows;Stage I,74.8%;stage II,9.7%;stage III,11.3%;and stage IV,4.8%.Forty-three(67.7%)patients received adjuvant chemotherapy.With a median follow-up time of 96.3 mo,the 10-year progressionfree survival and overall survival were 82.4%and 91%,respectively.For reproductive outcomes,of 43 patients who received adjuvant chemotherapy,18(41.9%)had normal menstruation,and 17(39.5%)resumed menstruation with a median time of 4 mo.Of about 14 patients who desired to conceive,four were pregnant and delivered good outcomes.Only one case was aborted.Therefore,the successful pregnancy rate was 28.6%CONCLUSION The oncology and reproductive outcomes of MOGCT treated by FSS are excellent.Many patients show a long survival time with normal menstruation.However,the obstetric outcome is not quite satisfactory.展开更多
A 16-year-old girl was administered to our hospital because of primary amenorrhea and solid pelvic mass. She was 158 cm tall and weighed 55 kg. There was no evidence ofacanthosis nigricans, acne, hirsutism, goiter, cu...A 16-year-old girl was administered to our hospital because of primary amenorrhea and solid pelvic mass. She was 158 cm tall and weighed 55 kg. There was no evidence ofacanthosis nigricans, acne, hirsutism, goiter, cushingoid features, or Turners stigmata. Examination of secondary sexual characteristics revealed that the breast was small and poorly developed （Tanner＇s Stage II）. Pubic hair was absent while the external genitalia was of female type and had no evidence of clitoromegaly. Ultrasonography of the pelvis showed a solid mass diameter about 9 cm in right adnexal area, a normal uterus with endometrium of 3 ram, and left ovary 1.5 cm x1.0 cm. Her serum hormonal assay revealed a low estradiol level of 0.155 nmol/L （normal range： 0.200-0.790 nmol/L in follicular phase） in the background of elevated luteinizing hormone level of 25.47 U/L （normal range： 2.12-10.89 U/L in follicular phase）, follicle-stimulating hormone level of 51.36 U/L （normal range： 3.85-8.78 U/L in follicular phase）, and testosterone level of 3.97 nmol/L （normal range： 0.35-2.60 nmol/L）. She was found to have normal progesterone level of 3.77 nmol/L （0.98-4.83 nmol/L in follicular phase） and serum prolactin level of 12.47 ng/ml （3.34-26.72 ng/ml）.展开更多
文摘BACKGROUND Malignant ovarian germ cell tumors(MOGCT)are rare and frequently occur in women of young and reproductive age and the oncologic and reproductive outcomes after fertility-sparing surgery(FSS)for this disease are still limited.AIM To evaluate the oncology and reproductive outcomes of MOGCT patients who underwent FSS.METHODS All MOGCT patients who underwent FSS defined as the operation with a preserved uterus and at least one side of the ovary at our institute between January 2005 and December 2020 were retrospectively reviewed.RESULTS Sixty-two patients were recruited for this study.The median age was 22 years old and over 77%were nulliparous.The three most common histology findings were immature teratoma(32.2%),dysgerminoma(24.2%),and yolk sac tumor(24.2%).The distribution of stage was as follows;Stage I,74.8%;stage II,9.7%;stage III,11.3%;and stage IV,4.8%.Forty-three(67.7%)patients received adjuvant chemotherapy.With a median follow-up time of 96.3 mo,the 10-year progressionfree survival and overall survival were 82.4%and 91%,respectively.For reproductive outcomes,of 43 patients who received adjuvant chemotherapy,18(41.9%)had normal menstruation,and 17(39.5%)resumed menstruation with a median time of 4 mo.Of about 14 patients who desired to conceive,four were pregnant and delivered good outcomes.Only one case was aborted.Therefore,the successful pregnancy rate was 28.6%CONCLUSION The oncology and reproductive outcomes of MOGCT treated by FSS are excellent.Many patients show a long survival time with normal menstruation.However,the obstetric outcome is not quite satisfactory.
文摘A 16-year-old girl was administered to our hospital because of primary amenorrhea and solid pelvic mass. She was 158 cm tall and weighed 55 kg. There was no evidence ofacanthosis nigricans, acne, hirsutism, goiter, cushingoid features, or Turners stigmata. Examination of secondary sexual characteristics revealed that the breast was small and poorly developed （Tanner＇s Stage II）. Pubic hair was absent while the external genitalia was of female type and had no evidence of clitoromegaly. Ultrasonography of the pelvis showed a solid mass diameter about 9 cm in right adnexal area, a normal uterus with endometrium of 3 ram, and left ovary 1.5 cm x1.0 cm. Her serum hormonal assay revealed a low estradiol level of 0.155 nmol/L （normal range： 0.200-0.790 nmol/L in follicular phase） in the background of elevated luteinizing hormone level of 25.47 U/L （normal range： 2.12-10.89 U/L in follicular phase）, follicle-stimulating hormone level of 51.36 U/L （normal range： 3.85-8.78 U/L in follicular phase）, and testosterone level of 3.97 nmol/L （normal range： 0.35-2.60 nmol/L）. She was found to have normal progesterone level of 3.77 nmol/L （0.98-4.83 nmol/L in follicular phase） and serum prolactin level of 12.47 ng/ml （3.34-26.72 ng/ml）.
