Germ cell tumours

Question 1

Most common demographic of germ cell tumors?

Answer 1

Adolescent girls

Question 2

Types of germ cell tumours

Answer 2

1. Teratoma
2. Dysgerminoma
3. Yolk sac tumour
4. Choriocarcinoma

Question 3

Which is the most common type of germ cell tumor?

Answer 3

Teratoma accounts for 90% of germ cell tumours

Question 4

Teratoma definition

Answer 4

Benign - dermoid cyst
Malignant - Teratoma
Contain a combination of ectodermal (e.g. hair), mesodermal (e.g. bone) and endodermal tissue

Question 5

Prevalence of Dysgerminoma

Answer 5

Most common malignant germ cell tumour

Question 6

Dysgerminomas - how does it present

Answer 6

1. Bilateral in 20% of cases

2. Secrete BhCG

Question 7

What do Dysgerminomas secrete

Answer 7

Beta HCG and LDH

Question 8

What condition is Dysgerminoma associated with

Answer 8

Turner’s syndrome

Question 9

Yolk sac tumor

Answer 9

second most common germ cell tumor

• is malignant
• 15% of all germ cell tumors

Question 10

Which tumor secretes AFP?

Answer 10

Yolk sac tumors

Question 11

How do yolk sac tumors present?

Answer 11

1. Rarely bilateral

2. Large solid mass which presents acutely with torsin

Question 12

Choriocarcinoma demographic

Answer 12

1. Very rare

2. Present in young girls with irregular bleeding and high Beta HCG level

Question 13

Choriocarcinoma - what is it characterised by?

Answer 13

1. Malignant
2. Part of gestational trophoblastic disease
3. Characterised by early haematogenous spread to the lungs

Question 14

How do germ cell tumors characteristically present?

Answer 14

1. Woman presents with a large solid ovarian mass which is rapidly growing
2. May also present acute with torsion

Question 15

Ix of Germ cell tumours

Answer 15

1. Tumor markers
2. MRI - assess morphology
3. CT scan of liver and lymph noodes
4. Chest X ray to exclude pulmonary metastases