Ovarian germinoma (dysgerminoma) with elevated serum lactic dehydrogenase: case report and review of literature.

lactic dehydrogenase (LDH) is a glycolytic enzyme that may be elevated in the serum of patients with gonadal and extragonadal germinomas. In this report, the authors describe a young woman with a unilateral ovarian pure germinoma (dysgerminoma) who had greater than a sixfold elevation of serum LDH levels with increases in LDH isoenzymes 1, 2, and 3. Two weeks after operation, the serum LDH level had returned to normal. Four additional examples of ovarian germinoma with elevated serum LDH levels have been recorded in the literature. The germinoma cells are the likely source of the elevated LDH activity in such cases. Lactic dehydrogenase and its isoenzymes may serve as a useful tumor marker for diagnosis and posttherapy surveillance in patients with germinomas (dysgerminomas, seminomas). The association of elevated serum LDH in patients with other neoplasms is also reviewed.