460 Obstetrics and Gynecology Board Review •••
❍ What is the most common malignant germ cell tumor?
Dysgerminoma.
❍ What is the second most common malignant germ cell tumor?
Immature teratoma.
❍ Describe the histologic characteristics of dysgerminomas.
Large round ovoid or polygonal cells with abundant clear, pale staining cytoplasm, large and irregular nuclei with
prominent nucleoli.
❍ What are the most common chemotherapeutic regimens for germ cell tumors?
(1) BEP (bleomycin, etoposide, and cisplatin).
(2) VBP (vinblastine, bleomycin, and cisplatin).
(3) VAC (vincristine, actinomycin, and cyclophosphamide).
❍ What tumor markers may be elevated in a woman with a dysgerminoma?
(1) Lactic dehydrogenase.
(2) Beta-hCG.
❍ Endodermal sinus tumors are derived from what structure?
The primitive yolk sac.
❍ The majority of malignant ovarian germ cell tumors are unilateral except for which type?
Dysgerminoma tumors can have bilateral involvement in 10% to 15% of cases.
❍ Which stage of ovarian germ cell tumors does not require any further treatment following surgical resection
and staging?
The treatment of choice for a woman with a stage IA dysgerminoma and a stage IA grade 1 immature teratoma is
observation.
❍ What is the characteristic microscopic finding of endodermal sinus tumors?
Schiller-Duval body.
❍ What enzymes are secreted by endodermal sinus tumors?
AFP and rarely, alpha-1-antitrypsin.
❍ What is the most common malignancy to develop in an initially benign teratoma?
Squamous cell carcinoma.
❍ How do you distinguish an embryonal carcinoma of the ovary from choriocarcinoma of the ovary?
There is an absence of syncytiotrophoblastic and cytotrophoblastic cells in an embryonal carcinoma.