Mitranovici Melinda-Ildiko, Chiorean Diana Maria, Turdean Sabin Gligore, Mureșan Maria Cezara, Buicu Corneliu-Florin, Moraru Raluca, Moraru Liviu, Cotoi Titiana Cornelia, Toru Havva Serap, Apostol Adrian, Mărginean Claudiu, Petre Ion, Oală Ioan Emilian, Ivan Viviana, Cotoi Ovidiu Simion
Department of Obstetrics and Gynecology, Emergency County Hospital Hunedoara, 14 Victoriei Street, 331057 Hunedoara, Romania.
Department of Pathology, County Clinical Hospital of Targu Mures, 540072 Targu Mures, Romania.
Reports (MDPI). 2023 Mar 3;6(1):14. doi: 10.3390/reports6010014.
Ovarian malignant germ cell tumors (OMGCTs) represent a rare type of malignant tumors composed of primitive germ cells that often originate from dysgenetic gonads and are frequently associated with hermaphroditism. Such tumors occur more frequently in adolescents or young adults, and their etiopathogenic mechanism is not well established. We report the case of a 20-year-old female with ovarian dysgenesis and female phenotype. A laparoscopic surgery was performed, and ovotestis was discovered. To achieve a histopathological examination, right oophorectomy was performed, which confirmed the diagnosis of dysgerminoma. In the case of hermaphroditism, mixed germ cell tumors can develop, leading to a more aggressive evolution with bilateral malignancy of the gonads, which requires the removal of both ovotestis. The patient was recalled. A histopathological examination revealed a seminoma, so laparoscopic left oophorectomy was performed. The management of this type of diagnosis primarily involves surgery, minimally invasive interventions being preferred. Not all pathologic conditions are readily identifiable by means of exploratory laparoscopy, as in our patient's case. We consider that the optimal solution for these patients would be the preservation of fertility via egg donation and embryo transfer; the survival rate of such patients being 97-100%, if the tumor is diagnosed at an early age.
卵巢恶性生殖细胞肿瘤（OMGCTs）是一种罕见的恶性肿瘤，由原始生殖细胞组成，通常起源于发育异常的性腺，且常与两性畸形相关。这类肿瘤在青少年或年轻成年人中更为常见，其发病机制尚未完全明确。我们报告一例20岁患有卵巢发育不全和女性表型的女性病例。进行了腹腔镜手术，发现了卵睾。为进行组织病理学检查，实施了右侧卵巢切除术，确诊为无性细胞瘤。在两性畸形的情况下，可发生混合性生殖细胞肿瘤，导致性腺双侧恶性病变，病情进展更为凶险，这需要切除双侧卵睾。该患者被召回。组织病理学检查显示为精原细胞瘤，于是进行了腹腔镜左侧卵巢切除术。这类诊断的治疗主要涉及手术，首选微创干预。并非所有病理情况都能通过探查性腹腔镜检查轻易识别，就像我们这位患者的情况一样。我们认为，对于这些患者，最佳解决方案是通过卵子捐赠和胚胎移植来保留生育能力；如果肿瘤在早期被诊断，这类患者的生存率为97 - 100%。
