Effusion Cytology of Dysgerminoma: A Case Report with Review of Literature

  • Meera Balakrishnan Department of Cytopathology Mubarak Al-Kabeer Hospital, Kuwait
  • Smiley Annie George Department of Histopathology, Mubarak Al-Kabeer Hospital, Kuwait
  • Anupama Arora Mallik Department of Histopathology, Mubarak Al-Kabeer Hospital, Kuwait
  • Mrinmay Kumar Mallik 1Department of Cytopathology Mubarak Al-Kabeer Hospital, Kuwait
Keywords: Ovary, Dysgerminoma, ascitic fluid cytology, pleural fluid cytology


Ovarian dysgerminoma is a rare malignant ovarian germ cell tumor (MOGT) with its peak incidence in women younger than 20 years. Peritoneal and pleural dissemination of ovarian tumors is a major prognostic parameter in ovarian malignancies. Effusion cytology of germ cell tumors are not frequently reported in the literature. We report a case of a MOGT in a 15 year old female who presented with severe painful abdominal distention and respiratory distress. Ascitic and pleural fluid cytology were positive for malignant cells which on immunocytochemistry supported the diagnosis of metastatic dysgerminoma. The histopathology of the ovarian mass was confirmed to be dysgerminoma FIGO stage IVA. This case report highlights the salient cytomorphologic features of metastatic dysgerminoma in ascitic and pleural fluid  discussing the differential diagnoses.


Kattan J, Droz J, Charpentier P, Michel G, Lhommé C, Boutan-Laroze A, et al. Ovarian dysgerminoma metastatic to the breast. Gynecologic Oncology. 1992 Jul;46(1):104-6.

Hyseni N, Llullaku S, Jashari H, Zahiti K, Hyseni F, Kurshumliu F, et al. Advanced Ovarian Dysgerminoma Infiltrating Both Ovaries and Uterus in a 7-Year-Old Girl. Case Reports in Oncological Medicine. 2014;2014:1-4.

Mandai M, Konishi I, Koshiyama M, Komatsu T, Yamamoto S, Nanbu K, et al. Ascitic Positive Cytology and Intraperitoneal Metastasis in Ovarian Dysgerminoma. Journal of Obstetrics and Gynaecology Research. 1996 Feb;22(1):89-94.

Zaloudek CJ (2011) ‘Pathology of Germ Cell Tumors’, in Diagnostic pathology of ovarian tumors.

Valente PT, Daniel Schantz H, Edmonds PR, Hanjani P. Peritoneal cytology of uncommon ovarian tumors. Diagn Cytopathol. 1992 Mar;8(2):98-106.

Schulte JJ, Lastra RR. Abdominopelvic washings in gynecologic pathology: A comprehensive review. Diagn Cytopathol. 2016 Dec;44(12):1039-57.

Kashimura M, Matsukuma K, Kamura T, Matsuyama T, Tsukamoto N. Cytologic findings in peritoneal fluids from patients with ovarian serous adenocarcinoma. Diagn Cytopathol. 1986 Jan;2(1):13-6.

Gupta R, Mathur SR, Arora VK, Sharma SG. Cytologic features of extragonadal germ cell tumors. Cancer. 2008 Nov 3;114(6):504-11.

Das DK. Serous effusions in malignant lymphomas: A review. Diagn Cytopathol. 2006 May;34(5):335-47.

Abadi MA, Zakowski MF. Cytologic features of sarcomas in fluids. Cancer. 1998 Apr 25;84(2):71-6.

Guo CC, Punar M, Contreras AL, Tu S, Pisters L, Tamboli P, et al. Testicular Germ Cell Tumors With Sarcomatous Components. American Journal of Surgical Pathology. 2009 Aug;33(8):1173-8.

Case Report