Malignant ovarian germ cell tumours
- Lesion
Fast-growing ovarian cancers of girls and young women; each makes its own blood marker, and most can be cured with surgery and chemotherapy.
What it is
Malignant germ cell tumours are rare and mostly affect girls and young women. Dysgerminoma is the ovarian counterpart of testicular seminoma, made of large clear cells with lymphocytes in the septa, and it is linked to dysgenetic gonads that carry a Y chromosome. Yolk sac tumour secretes alpha-fetoprotein and forms Schiller–Duval bodies. Non-gestational choriocarcinoma, embryonal carcinoma and mixed tumours are rarer. These tumours grow quickly, but they are highly chemosensitive and the serum markers track their response.
Structure
- Dysgerminoma: solid, soft, grey-white to tan lobulated tumour; uniform cells with central nuclei and clear cytoplasm in nests separated by lymphocyte-rich septa.
- Yolk sac tumour: varied patterns (reticular, microcystic, papillary); Schiller–Duval bodies and hyaline globules.
- Choriocarcinoma: haemorrhagic tumour with sheets of trophoblast and no villi.
- Mixed tumours: several germ cell components, each to be reported because they change treatment.
Step by step
- A primordial germ cell, or its precursor in a dysgenetic gonad, fails to differentiate normally.
- Retaining stem-cell programs (OCT3/4, NANOG), it grows as dysgerminoma.
- Cells that differentiate toward yolk sac, trophoblast or embryonic tissue form the other malignant types.
- Each line secretes its characteristic marker into the blood, which falls with successful treatment.
Malignant ovarian germ cell tumours and their markers
| Tumour | Testicular counterpart | Hallmark | Serum marker |
|---|---|---|---|
| Dysgerminoma | Seminoma | Clear cells, lymphocytes in septa | LDH (sometimes low hCG) |
| Yolk sac tumour | Yolk sac tumour | Schiller–Duval bodies, hyaline globules | AFP |
| Choriocarcinoma (non-gestational) | Choriocarcinoma | Trophoblast, haemorrhage, no villi | hCG |
| Embryonal carcinoma | Embryonal carcinoma | Primitive cells, CD30 | AFP and hCG may rise |
| Immature teratoma | Teratoma | Immature neuroepithelium | Usually none |
Markers
- OCT3/4, SALL4, KIT (dysgerminoma)
- Glypican-3 and AFP (yolk sac)
- hCG (choriocarcinoma)
- CD30 (embryonal carcinoma)
Clinical notes
- Present as a rapidly enlarging, painful pelvic mass in a girl or young woman, sometimes with torsion or rupture.
- Fertility-sparing surgery followed by platinum-based chemotherapy cures most patients.
- A primary amenorrhea with a dysgerminoma suggests a disorder of sex development with a Y chromosome.
Test yourself
Think of the answer, then tap the question to see it.
What is the ovarian counterpart of testicular seminoma?
Dysgerminoma.
What is a Schiller–Duval body?
A glomerulus-like structure with a central blood vessel covered by tumour cells, typical of yolk sac tumour.
Which serum marker is followed in a yolk sac tumour?
Alpha-fetoprotein (AFP).
Elsewhere in DurgiPedia
- Alpha-fetoprotein (AFP)
- Lactate dehydrogenase (LDH) as a lab marker
- Tumour markers: principles of use
- Differences of sex development: CAH, AIS and 5α-reductase
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Ovarian Germ Cell Tumors Treatment (PDQ®)–Health Professional Version (National Cancer Institute, 2026).
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Representative model, for educational purposes only.