••• Chapter 51^ Gynecologic Pathology^517
❍ In general, what is the prognosis for dysgerminoma?
It is excellent as the tumor is quite radiosensitive and responsive to chemotherapy. Thus, for a stage I tumor, the
5-year survival is almost 95%. Overall, the 5-year survival is between 70% and 90% for all tumors.
❍ A 17-year-old female has an ovarian tumor that has resulted in an elevated serum alpha-fetoprotein. What is
your diagnosis?
Endodermal sinus tumor.
❍ In an ovarian endodermal sinus tumor, what are some of the characteristic histologic features you would
expect to see?
Schiller-Duval bodies and eosinophilic globules that are PAS-positive and diastase resistant.
❍ What is the typical genotype and phenotype in patients with gonadoblastoma?
They are usually phenotypic females and genotypic males (have a Y chromosome).
❍ What are some conditions that increase the incidence of hydatidiform mole?
Poverty, poor nutrition, and extreme ends of reproductive life and consanguinity.
❍ What is the most common karyotype in complete hydatidiform mole (CHM) compared with partial
hydatidiform mole (PHM)?
In CHM, they are almost always 46XX and both “X”s are paternally derived (diandrogenic dispermy), while in
PHM, the majority are 69XXY with 69XXX representing up to 40% of cases.
❍ Which is at a greater risk for development of choriocarcinoma—CHM or PHM?
CHM results in choriocarcinoma in approximately 5% of cases.
❍ Which type of mole is associated with a higher level of beta-hCG?
The beta-hCG in CHM is usually twice than that of PHM.
❍ What is the most common germ cell tumor to occur bilaterally (approximately 10–20%)?
Dysgerminomas.