OVARIAN GERM CELL TUMORS
Malignant germ cell tumors of the ovary occur primarily in the second and third decades of life, although they are occasionally found in young girls and older women. The tumors are usually accompanied by abdominal pain, and almost 10% of patients will present with an acute episode of torsion, hemorrhage, or rupture of the tumor.
Herbal Phentermine
Germ cell tumors may be associated with elevated serum levels of the beta subunit of human chorionic gonadotropin (b-hCG), alpha-fetoprotein, or lactic dehydrogenase. Measurement of these markers may aid in the diagnosis of germ cell tumors and may be useful in management and follow-up care. Serum markers are shown in Table 13. There is considerable variation in markers, although most endodermal sinus tumors produce alpha-fetoprotein, and most choriocarcinomas and dysgerminomas produce b-hCG and lactic dehydrogenase, respectively.
TABLE 13. Serum Markers in Malignant Germ Cell Tumors of the Ovary*
Serum Marker
Malignant Germ Cell Tumor AFP b-hCG LDH CA 125
Endodermal sinus tumor + – + +
Embryonal carcinoma + + + +
Choriocarcinoma – + + +
Xanax Canadian
Immature teratoma + – + +
Dysgerminoma – + ± ±
Mixed germ cell tumor ± ± ± ±
*AFP indicates alpha-fetoprotein; b-hCG, beta subunit of human chorionic gonadotropin; LDH, lactic dehydrogenase. t Marker depends on the type of germ cell tumors present.
Cancer treatment
Prognosis is good for most patients treated with platinum-based multidrug chemotherapy. Table 14 displays the results of adjuvant chemotherapy in stage I and completely resected stage II and stage III patients with malignant germ cell tumors. Of 85 patients given adjunctive therapy of either bleomycin, etoposide, and platinum or platinum, vinblastine, and bleomycin, 83 (98%) were progression free. In comparison, patients who had residual disease, had persistent disease, or developed recurrences had a progression-free survival rate of only 59% (71/120 patients) when treated with similar regimens (Table 15).