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Clinicopathological Study of Ovarian Germ Cell Tumours in Tertiary Care Hospital, Tamil Nadu, India: A cross-sectional Study
Introduction: Ovarian germ cell tumours are a heterogeneous
group of neoplasms derived from primitive germ cells of the
embryonic gonad, either directly or indirectly. They can be
classified as benign and malignant, with slow and rapid growth
and spread, respectively. Benign ovarian germ cell tumours are
common, while malignant tumours are rare and account for
about 2.6% of all ovarian malignancies. They are more common
in the second and third decades of life and typically present with
abdominal mass, pain, and elevated serum tumour markers,
which aid in primary diagnosis and follow-up.
Aim: To analyse the distribution of germ cell tumours in
the ovary in relation to age, parity, mode of presentation,
biochemical markers, histomorphological patterns, and
immunohistochemical markers.
Materials and Methods: This cross-sectional study was
conducted at Department of Pathology, Sree Balaji Medical
College, Hospital and Research Institute, Chromepet, Chennai,
Tamil Nadu, India. The study involved 86 ovarian specimens,
of which 25 were germ cell tumours. Complete clinical history,
radiological findings, and pre-operative laboratory test values
were recorded. The ovarian specimens were carefully examined
for gross appearances, fixed in 10% neutral buffered formalin
for 24-48 hours, and subjected to histopathological processing,
routine and special staining, and immunohistochemical study
after observing the different morphological patterns of the
ovarian specimens received.
Results: The age range of presentation was between 14 years
and 58 years. Seventeen patients were parous (14 benign
and 3 malignant), and eight (5 benign and 3 malignant) were
nulliparous. Abdominal mass and abdominal pain were the most
common modes of presentation. Out of 25 germ cell tumours,
19 were benign cystic mature teratomas, 2 were immature
teratomas, 1 was a yolk sac tumour, 2 were dysgerminomas,
and 1 was a carcinoid tumour, with 6 being malignant and 19
being benign tumours. Among the 6 malignant ovarian tumours,
5 cases had raised serum tumour markers {cancer antigen-125
(CA-125), Alpha-Fetoprotein (AFP)} pre-operatively, and the
levels reduced and became normal after surgery. Among the
2 cases of immature teratoma, one was Grade-II and the other
was Grade-III. For one case with mixed tumour components,
CD-30 and α-fetoprotein immunohistochemical markers were
performed, showing negative and positive results, respectively.
Conclusion: Among the histopathological subtypes, benign
cystic teratomas were the most common ovarian germ cell
tumours in this study. Both benign and malignant tumours
presented with abdominal pain and abdominal mass. Most of the
tumours were diagnosed between the ages of 21 and 40 years. In
this study, α-fetoprotein immunohistochemical marker showed
strong positivity, confirming a single tumour component