Malignant Germ cell Tumor of Ovary: An Unusual Combination and An Irony of Fate

  • Arpita Sutradhar Pathology, Apollo Gleneagles Hospital
  • Enam Murshed Khan Pathology, Apollo Gleneagles Hospital
  • Shaikat Gupta Surgical Oncology, Apollo Gleneagles Hospital
  • Sudipta Kumar Maitra Surgical Oncology, Apollo Gleneagles Hospital
  • Somdeep Ghosh Surgical Oncology, Apollo Gleneagles Hospital
Keywords: Malignant mixed germ cell tumor, dysgerminoma, endodermal sinus tumor, fertility


Malignant mixed ovarian germ cell tumors are very rare malignant ovarian germ cell tumors, with a very high degree of malignancy. They are aggressive cancers affecting young adolescent girls. The commonest combination reported in literature is dysgerminoma and endodermal sinus tumors. Fertility sparing surgery followed by combination chemotherapy is the treatment of choice. The objectives of this case report are the advanced age of presentation, unusual histopathological combination, and the irony of infertility treatment. We report a rare case of 40-year-old woman with Malignant mixed germ cell tumor comprising of components of endodermal sinus tumor, immature teratoma, dysgerminoma and embryonal carcinoma. Patient was on hormonal therapy for the cause of infertility, presented with complains of lower abdominal pain, constipation and incomplete evacuation of bladder for 2months. Transvaginal ultrasonography and CT scan showed a large multicystic space occupying lesion with predominant solid component in midline abdominopelvic location. Tumor markers i.e., AFP, Prolactin and CA125 were raised. Total abdominal hysterectomy and bilateral salpingoophorectomy, pelvic and retroperitoneal node resection, peritonectomy and omentectomy was performed.


Brown J, Friedlander M, Backes FJ, et al. Gyanecologic Cancer Inter-group (GCIG) consensus review for ovarian germ cell tumors. Int J Gynaecol Cancer .2014;242014;24(9 Suppl 3):S48-S54.

Talerman A. Germ cell tumors of the ovary. In: Kurman RJ, ed. Blaustein’s pathology of the female genital tract.5th ed. New York, NY: Springer ,2002;1391.

Lim FK, Chanrachakul B, Chomg SM, Ratnma SS: Malignant ovarian germ cell tumors: experience in National University Hospital of Singapore. Ann Acad Med Singapore 1998,27(5):657-661.

Gershenson DM, Del Junco G, copelan LJ, Ruthledge FN: Mixed germ cell tumors of ovary. Obstet Gynaecol 1984,64(2):200-206.

Munemane a, Munemame M. Malignant mixed germ cell tumors of the ovary-a report of 2 J Med Sci Public Health .2014;3(1):105-7.

Brammer HM 3rd, Buck JL, Hayes WS, Sheth S, Tassavoli FA: From the archives of AFIP. Malignant germ cell tumors of the ovary: radiologic-pathologic correlation. Radiographics 1990,10:715-724.

Norris HJ, Jensen RD. Relative frequency of ovarian neoplasms in children and adolscents. Cancer 1972;30(3):713-719.

Lajya DG, Balpreet K, Rama KB. Malignant Mixed Germ cell tumors of the Ovary: A series of Rare cases: Original Article .J Reprod Infertil. 2019;20(4):231-236

Case Report