Dysgerminomas: What are they? Causes, Symptoms, Diagnosis and Treatment

They are considered the most common classification of the malignant form of germ cell ovarian cancer.

Dysgerminomas generally occur in adolescence and early adult life, about 5% occur in prepubertal children.

Dysgerminomas are known to be an extremely rare medical condition that generally occurs after the age of 50.

Dysgerminomas occur in both sections of the ovaries in more than 10% of patients, and a microscopic tumor that developed in the other ovary is found in an additional 10%.

They constitute two-thirds of all malignant ovarian neoplasms in women younger than 20 years.

They are a germ cell tumor of the ovary that is usually malignant in nature, right from the start.

Dysgerminomas are the most common malignant germ cell ovarian cancer.

Ovarian carcinoma tumors are epithelial in nature and it is by their inherent nature that they metastasize to different parts of the body such as the lungs and liver, among other organs.

The most common form of metastasis in carcinomas is through the lymph nodes.

When cells are shed from the original tumor, they travel to the lymph nodes, causing secondary cancer. Lymphadenopathy is seen frequently in all carcinomas.

This carcinoma has a characteristic nature that is the highest incidence of carcinoma in adolescents. It occurs mainly in virgin girls, in their early adult life.

In prepubertal girls, its occurrence is around 5%. It also occurs in married women in the age group between 20 and 30 years.

After the menopausal periods, their appearance is almost unusual. Its male or testicular counterpart is the seminoma.

Dysgerminomas correspond exactly to their male homologous seminoma, histologically and pathologically.

Of all twin cell tumors of the ovaries, dysgerminomas are the most common malignant ovarian germ cell tumor.

Chromosome 12p abnormalities are the genetic characteristics of testicular seminomas. Genetic changes or mutations in dysgerminomas have not yet been discovered.

All dysgerminomas are considered malignant, but only one third of dysgerminomas behave aggressively.

In addition to dysgerminomas, the other germ cell tumors found in the ovaries are:

  • Endodermal sinus tumor.
  • Embryonic carcinoma.
  • Polybromy.
  • Choriocarcinoma.
  • Teratoma.

Causes of dysgerminomas

The cause of dysgerminomas is not fully understood.

A number of inherited defects have also been associated with an increased risk of developing germ cell tumors, including central nervous system and genitourinary tract malformations and major malformations of the lower spine.

Symptoms

Unfortunately, women with ovarian tumors often have no symptoms for a long time, this is a very tragic reality of all ovarian cancers.

Many women with early stages of ovarian carcinoma have no symptoms at all, or they are not specific.

The early symptom-free nature of ovarian cancer makes it more difficult to detect and diagnose.

Unfortunately, when ovarian neoplasia is diagnosed, two-thirds of women have advanced carcinoma.

The prognosis in such cases remains totally unfavorable.

Abdominal symptoms, including pressure, pain, pelvic pressure, lower back discomfort, mild nausea, a feeling of early fullness when eating, constipation, and gas, are all non-specific in nature.

In their early manifestation, dysgerminomas are almost completely symptom-free or asymptomatic in the early stages.

Abnormal bleeding during menstruation should raise alarm and suspicion, but is not specific.

The symptoms can be summarized as:

  • Asymptomatic in the early stages of growth and development.
  • Pelvic pain.
  • Excessive and abnormal bleeding during menstruation.
  • Disuria.
  • Increased frequency of urination.
  • Mild abdominal symptoms.
  • Pelvic fullness.

Diagnosis of dysgerminomas

Metastasis has been observed in approximately 22% of cases at the time of diagnosis.

Germinomas are known to be among the most commonly diagnosed disorders between the ages of 10 and 21.

Both serum and spinal fluid found in the tumor are often key markers for human alpha fetoprotein and beta choriogonadotropin, however pure germinomas are not associated with these markers on some occasions.

Non-germ-type germ cell tumors may be associated with increased markers, such as alpha fetoprotein, which comes with yolk sac tumors along with immature teratomas, embryonal cell carcinomas, and human beta choriogonadotropin, which typically occur in choriocarcinomas.

It is also observed that a low level of human beta choriogonadotropin can be produced in approximately 1 to 15% of germinones.

While this has been considered highly controversial, there are some supporting theories and thoughts that state that human choriogonadotropin-secreting germinomas are more common and more aggressive than non-secreting germinomas.

In addition to a complete medical history and physical exam, diagnostic procedures for germ cell tumors may include:

  • Biopsy: A sample of tissue is removed from the tumor and examined under a microscope.
  • Complete blood count: This measures the size, number, and maturity of blood cells in a given volume of blood.
  • Additional blood tests : These tests may include evaluation of liver and kidney functions, tumor cell markers, and genetic studies.
  • Imaging studies: These include CT, MRI, X-rays, ultrasound, also called sonography, and bone scans.

Treatment

In early stage cancer, both ovaries are operated on or removed.

If the malignancy is very advanced and the uterus must be removed, surgical measures of radiotherapy and chemotherapy are used. These techniques have their own complications.

Honestly speaking, the prognosis for ovarian cancer is not promising but rather shocking and agonizing.

With regular administration of treatment, the chances of patients enjoying long-term survival, even achieving complete healing and recovery, are increased, and they have excellent opportunities.