Germ cell tumours (GCTs) of the ovary are rare, comprising approximately 20% of all ovarian tumors with the malignant variant accounting for less than 5% of all ovarian neoplasms. Malignant mixed germ cell tumours are...Germ cell tumours (GCTs) of the ovary are rare, comprising approximately 20% of all ovarian tumors with the malignant variant accounting for less than 5% of all ovarian neoplasms. Malignant mixed germ cell tumours are rarer still with dysgerminoma & yolk sac tumour being the most common components with three component variants being categorised in the rarest of rare varieties. Bilateral dysgerminomas occur in 15% of germ cell neoplasms but rarely present with premature ovarian failure. We present the case of an adolescent girl with a short history of abdominal pain and distension with amenorrhoea for a year. Clinical and radio ogical examination revealed a pelvic/adnexal mass with elevation of tumour markers and she had to undergo a staging laparotomy with bilateral salpingo-oophorectomy. Histopatholgy examination was reported as malignant mixed germ cell tumour of left ovary, predominantly with immature teratoma and minor components of yolk-sac tumour and dysgerminoma and right ovary with dysgerminoma. In view of mixed germ cell disease, she was planned for adjuvant chemotherapy.展开更多
5%of all ovarian tumours are accounted to germ cell tumours(GCT’s).Affecting mostly young women,the highest incidence is seen in second and third decade of life.They are highly malignant but chemosensitive and more c...5%of all ovarian tumours are accounted to germ cell tumours(GCT’s).Affecting mostly young women,the highest incidence is seen in second and third decade of life.They are highly malignant but chemosensitive and more curable than their epithelial counterparts.Treating these tumors with effective surgery and combination chemotherapy survival rates have dramatically improved in recent decades.We present our experience of ovarian germ cell tumours in the department of Surgical Oncology,Rajendra Institute of Medical Sciences(RIMS),Ranchi with special emphasis on treatment outcomes.A retrospective review of hospital medical records of patients with ovarian germ cell tumours diagnosed and treated at RIMS from June 2019 to August 2020,was performed.Clinical profile and treatment outcome of patients were recorded.A total of 19 patients met criteria.The median age at diagnosis was 20 years(range 11-42 years)and all had good performance status.All except two patients underwent surgery,70.6%and 29.4%in upfront and interval debulking surgery(IDS)setting respectively.Fertility preserving surgery was done in 75%patients in the primary surgery group and 60%undergoing IDS.83.3%patients received BEP as adjuvant chemotherapy whereas 80%as neo-adjuvant chemotherapy.Majority(31.5%)patients had dysgerminoma as final histology,followed by mixed histology(26.3%),yolk sac tumour(15.7%),immature teratoma(15.7%)and choriocarcinoma(10.5%).47.3%patients were in Stage I at the time of diagnosis.78.9%patients were alive without disease,10.5%recurred,and 10.5%were lost to follow up.展开更多
Metastatic spread of testicular cancer has been well documented,with 95% of cases involving para-aortic retroperitoneal lymph nodes.Mesenteric lymphatic basins do not lie within the canonical drainage pathway of the t...Metastatic spread of testicular cancer has been well documented,with 95% of cases involving para-aortic retroperitoneal lymph nodes.Mesenteric lymphatic basins do not lie within the canonical drainage pathway of the testes and represent a rare site of metastasis.Various mechanisms of spread to the mesentery have been described,including direct extension and haematogenous dissemination.We present a case of a previously-well 43-year-old man who presented with right scrotal discomfort and intermittent lower back pain,who was found to have mesenteric metastases from a non-seminomatous germ cell tumour of the testis.Managing lymphadenopathy that lies outside of standard resection templates remains a complex surgical challenge.Here we present the first case in the English medical literature with co-existing supradiaphragmatic axillary and mediastinal nodal disease.展开更多
We report here the case of a young man suffering from a rare germ cell tumour. The patient was a 25-year-old man who was referred to our centre for asthenia, stinging epigastric pain, and an iron deficiency anaemia. G...We report here the case of a young man suffering from a rare germ cell tumour. The patient was a 25-year-old man who was referred to our centre for asthenia, stinging epigastric pain, and an iron deficiency anaemia. Gastroscopy revealed a circumferential vegetating lesion on the second portion of the duodenum. The lesion was indurated at the third portion of the duodenum, responsible for a tight stenosis. A computerized tomography-scan of the chest, abdomen and pelvis, and a pancreatic MRI showed a circumferential lesion with a bi-ductal dilatation (i.e., of the common bile duct and Wirsung’s duct) without metastatic localisation. The patient underwent a pancreaticoduodenectomy with lymph node dissection including all cellular adipose tissues of the hepatic pedicle from the hepatic common artery and of the retroportal lamina. Histological findings were suggestive of a duodenal embryonal carcinoma with pancreatic infiltration. This is the second published case highlighting the duodenal primitive localisation of an embryonal carcinoma with pancreatic infiltration.展开更多
文摘Germ cell tumours (GCTs) of the ovary are rare, comprising approximately 20% of all ovarian tumors with the malignant variant accounting for less than 5% of all ovarian neoplasms. Malignant mixed germ cell tumours are rarer still with dysgerminoma & yolk sac tumour being the most common components with three component variants being categorised in the rarest of rare varieties. Bilateral dysgerminomas occur in 15% of germ cell neoplasms but rarely present with premature ovarian failure. We present the case of an adolescent girl with a short history of abdominal pain and distension with amenorrhoea for a year. Clinical and radio ogical examination revealed a pelvic/adnexal mass with elevation of tumour markers and she had to undergo a staging laparotomy with bilateral salpingo-oophorectomy. Histopatholgy examination was reported as malignant mixed germ cell tumour of left ovary, predominantly with immature teratoma and minor components of yolk-sac tumour and dysgerminoma and right ovary with dysgerminoma. In view of mixed germ cell disease, she was planned for adjuvant chemotherapy.
文摘5%of all ovarian tumours are accounted to germ cell tumours(GCT’s).Affecting mostly young women,the highest incidence is seen in second and third decade of life.They are highly malignant but chemosensitive and more curable than their epithelial counterparts.Treating these tumors with effective surgery and combination chemotherapy survival rates have dramatically improved in recent decades.We present our experience of ovarian germ cell tumours in the department of Surgical Oncology,Rajendra Institute of Medical Sciences(RIMS),Ranchi with special emphasis on treatment outcomes.A retrospective review of hospital medical records of patients with ovarian germ cell tumours diagnosed and treated at RIMS from June 2019 to August 2020,was performed.Clinical profile and treatment outcome of patients were recorded.A total of 19 patients met criteria.The median age at diagnosis was 20 years(range 11-42 years)and all had good performance status.All except two patients underwent surgery,70.6%and 29.4%in upfront and interval debulking surgery(IDS)setting respectively.Fertility preserving surgery was done in 75%patients in the primary surgery group and 60%undergoing IDS.83.3%patients received BEP as adjuvant chemotherapy whereas 80%as neo-adjuvant chemotherapy.Majority(31.5%)patients had dysgerminoma as final histology,followed by mixed histology(26.3%),yolk sac tumour(15.7%),immature teratoma(15.7%)and choriocarcinoma(10.5%).47.3%patients were in Stage I at the time of diagnosis.78.9%patients were alive without disease,10.5%recurred,and 10.5%were lost to follow up.
文摘Metastatic spread of testicular cancer has been well documented,with 95% of cases involving para-aortic retroperitoneal lymph nodes.Mesenteric lymphatic basins do not lie within the canonical drainage pathway of the testes and represent a rare site of metastasis.Various mechanisms of spread to the mesentery have been described,including direct extension and haematogenous dissemination.We present a case of a previously-well 43-year-old man who presented with right scrotal discomfort and intermittent lower back pain,who was found to have mesenteric metastases from a non-seminomatous germ cell tumour of the testis.Managing lymphadenopathy that lies outside of standard resection templates remains a complex surgical challenge.Here we present the first case in the English medical literature with co-existing supradiaphragmatic axillary and mediastinal nodal disease.
文摘We report here the case of a young man suffering from a rare germ cell tumour. The patient was a 25-year-old man who was referred to our centre for asthenia, stinging epigastric pain, and an iron deficiency anaemia. Gastroscopy revealed a circumferential vegetating lesion on the second portion of the duodenum. The lesion was indurated at the third portion of the duodenum, responsible for a tight stenosis. A computerized tomography-scan of the chest, abdomen and pelvis, and a pancreatic MRI showed a circumferential lesion with a bi-ductal dilatation (i.e., of the common bile duct and Wirsung’s duct) without metastatic localisation. The patient underwent a pancreaticoduodenectomy with lymph node dissection including all cellular adipose tissues of the hepatic pedicle from the hepatic common artery and of the retroportal lamina. Histological findings were suggestive of a duodenal embryonal carcinoma with pancreatic infiltration. This is the second published case highlighting the duodenal primitive localisation of an embryonal carcinoma with pancreatic infiltration.
