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Dysgerminomas are one of the germ cell tumours of the ovaries. They are the most common malignant germ cell ovarian carcinoma. Most dysgerminomas occur in adolescence and early adult life; 5% occur in pre-pubertal patients, and they are extremely rare after age 50.
Abnormal gonads (gonadal dysgenesis and androgen insensitivity syndrome) have a high risk of developing a dysgerminoma. Most dysgerminomas are associated with elevated serum lactic dehydrogenase (LDH) which is sometimes used as a tumour marker. Dysgerminomas present as bilateral tumours in 10% of patients and, in a further 10%, there is microscopic tumour in the other ovary.
On gross examination, they have a smooth, bosselated external surface, which is soft, fleshy and cream-coloured, gray, pink or tan when cut. Microscopy reveals uniform cells that resemble primordial germ cells.
Typically, the stroma contains lymphocytes and 20% have sarcoid-like granulomas. Metastases are most often lymphatic, and dysgerminomas are exquisitely sensitive to chemotherapy and radiotherapy, making prognosis excellent.