How are malignant ovarian germ cell tumors (GCTs) diagnosed?

Updated: Aug 10, 2020
  • Author: Andrew E Green, MD; Chief Editor: Yukio Sonoda, MD  more...
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If a malignant germ cell tumor (GCT) is suspected at presentation, blood should be examined for tumor markers, including beta human human chorionic gonadotropin (beta-hCG), alpha-fetoprotein, and lactate dehydrogenase. In premenarchal girls found to have an adnexal mass, perform karyotyping to determine the status of the sex chromosomes.

Other investigations include chest x-ray for lung metastases and ultrasound to help define the morphology of the pelvic tumor, to help evaluate the kidneys for evidence of ureteric obstruction, and to help detect ascites and the presence of metastases in the liver and retroperitoneum. Preoperative CT scan or MRI may document intra-abdominal disease, including liver or lymph node metastases that are deemed undetectable on ultrasound imaging.

Patients with immature teratomas will not have elevated levels of tumor markers unless the tumor contains elements of other GCTs. The cardinal histologic feature is immature elements, mostly of neural tissue.

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