Youssef Reda, Ahmed Gamal Sayed, Alhyassat Samir, Badr Sanaa, Sabry Ahmed, Kohla Samah
Department of Clinical Imaging, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar.
Weill-Cornell Medical College, Doha, Qatar.
Case Rep Oncol. 2021 Mar 1;14(1):141-146. doi: 10.1159/000513622. eCollection 2021 Jan-Apr.
Dysgerminoma is an uncommon malignant tumor arising from the germ cells of the ovary. Its association with pregnancy is extremely rare, with a reported incidence of about 0.2-1 per 100,000 pregnancies. Women in the reproductive age group are more commonly affected. It can be extremely rare to conceive naturally, without assisted reproductive interventions, in cases with ovarian dysgerminoma. If a pregnancy does occur with a concurrent dysgerminoma, it is even more unusual to carry the pregnancy to viability or childbirth without fetal or maternal compromise. We report a case of right ovarian dysgerminoma in a young female with a viable intrauterine pregnancy at 10 weeks, which is rarely diagnosed and managed at this gestational age. Numerous factors played a role in her favorable outcome, including early suspicion by ultrasound and presenting history, surgery, histopathological assessment, imaging, and involvement of the multidisciplinary oncology team. Ovarian neoplasms may rapidly increase in size within a short period with little or no symptoms. This poses a diagnostic challenge for obstetricians and oncologists. Hence, we aimed to evaluate the role of imaging in pregnancy using ultrasound as an imaging modality for both early detection of ovarian neoplasms and for follow-up. In conclusion, patients with ovarian dysgerminoma in pregnancy can have favorable outcomes. Treatment should be individualized on a case-to-case basis, depending on many factors; cancer stage, previous reproductive history, the impact of imaging in staging or follow-up of tumor on the fetus, fetal gestational age, and whether termination of the pregnancy can improve survival or morbidity for the mother.
无性细胞瘤是一种罕见的起源于卵巢生殖细胞的恶性肿瘤。其与妊娠的关联极为罕见，据报道每10万例妊娠中的发生率约为0.2 - 1例。育龄期女性更易受影响。在患有卵巢无性细胞瘤的病例中，自然受孕（无辅助生殖干预）极为罕见。如果在患有无性细胞瘤的同时发生妊娠，在不危及胎儿或母亲的情况下将妊娠维持至胎儿存活或分娩则更为罕见。我们报告一例年轻女性右卵巢无性细胞瘤合并10周宫内活胎的病例，在这个孕周很少被诊断和处理。众多因素促成了她良好的结局，包括超声早期怀疑及病史、手术、组织病理学评估、影像学检查以及多学科肿瘤团队的参与。卵巢肿瘤可能在短时间内迅速增大且很少或没有症状。这给产科医生和肿瘤学家带来了诊断挑战。因此，我们旨在评估超声作为一种影像学手段在妊娠中对卵巢肿瘤早期检测及随访的作用。总之，妊娠合并卵巢无性细胞瘤的患者可以有良好的结局。治疗应根据具体情况个体化，取决于许多因素：癌症分期、既往生育史、肿瘤分期或随访中的影像学检查对胎儿的影响、胎儿孕周以及终止妊娠是否能改善母亲的生存或发病率。
