A form of abnormal growth that often affects people under 30 and develops in the reproductive cells (also called germ cells) inside the ovaries is called ovarian germ cell tumors. While most of these growths are benign (noncancerous), sometimes they may be malignant (cancerous). Most of the time, these growths are treated with surgery, but doctors may recommend additional treatments when the tumor is cancerous (malignant).
Generally, the ovaries are 2 small pelvic organs that are a very important part of the female reproductive system. They produce eggs in the reproductive years. Moreover, the germ cells in the ovaries mature into eggs. Sometimes, people may develop abnormal growths when these germ cells clump together. In most cases, these tumors affect only one ovary, but sometimes they can affect both.
In addition, most of them are benign, but in some people, they can be cancerous. Without treatment, these tumors can break and spread to other parts of the body. In general, malignant germ cell tumors are considered a rare form of ovarian cancer.
These tumors are the most common form of tumors in females in their reproductive years. Approximately 70% of ovarian growths occur in people between the ages of 10 and 30. Moreover, about 95% of ovarian germ cell tumors are benign (also known as mature teratomas).
Types of Ovarian Germ Cell Tumors
In general, there are multiple types of these tumors. Check the most common of them below:
- Mature teratoma (dermoid cyst) – This is the most common form of ovarian germ cell tumors. Mostly, it is diagnosed in their 20s or 30s.
- Dysgerminoma – This is one of the most common malignant ovarian germ cell tumors. Fortunately, more than 70% of them are not aggressive (fast-spreading) and are successfully treated. They also occur in their 20s or 30s.
- Immature teratoma – This is an aggressive form of malignant ovarian germ cell tumor that can spread from the ovary to other parts of the body. In such cases, the condition is called a metastatic ovarian germ cell tumor. It commonly affects people in their 20s or younger.
- Yolk sac tumors (also known as endodermal sinus tumors) – These tumors are also malignant, and they often grow and spread quickly. Moreover, about 40% of diagnoses involve children who are too young to have menstrual periods.
- Mixed germ cell tumors – Sometimes, people may develop a mix of other tumors along with ovarian germ cell tumors. In most cases, dysgerminoma and yolk sac tumors.
There are other forms of ovarian germ cell tumors, but they occur rarely. These include embryonal carcinoma, choriocarcinoma, and polyembryoma.
Symptoms
In the early stages of ovarian germ cell tumors, people often do not experience any symptoms. However, benign tumors may cause symptoms when they become large, and malignant tumors often cause symptoms in advanced stages. Check some symptoms below:
- Abdominal (belly) tenderness, discomfort, or pain (sometimes, it may start suddenly and be severe)
- Bloating (with or without gain in other parts of the body)
- Changes in bowel habits (including diarrhea or constipation)
- Eating habit changes (such as appetite changes)
- Irregular vaginal bleeding (for example, bleeding after the menstrual period or menopause)
These tumors may also release some hormones that often cause changes in the body, including early pregnancy (such as extreme tiredness, nausea, or breast tenderness) or early puberty (rarely). Immediately contact your healthcare professional if any of the previous symptoms occur.
Causes
While anyone can develop ovarian germ cell tumors, they often develop in the reproductive years or earlier. In general, these tumors appear due to certain genetic changes (mutations) that lead the germ cells to grow and multiply abnormally. When these abnormal cells become too numerous, they form a mass called a tumor. Currently, experts continue to research why these changes occur and who is at risk of developing them.
What Are The Potential Complications of Ovarian Germ Cell Tumors?
People who develop ovarian germ cell tumors (either benign or malignant) may also experience some complications, especially without treatment. Check some examples below:
- Ovarian torsion – In some cases, a fast-growing tumor may twist the ovary, causing reduced or a lack of blood flow and severe pain.
- Hemorrhage/rupture – Some of these tumors can rupture and cause bleeding in the abdominal area.
- Ascites – This complication causes fluid buildup in the abdomen. In more severe cases, it may cause shortness of breath (dyspnea).
- Infertility
- Chemotherapy adverse reactions, including damage to other organs, secondary cancers, nausea, and others.
- Hormonal problems – There are some subtypes that can negatively affect hormone production.
- Psychological impact – For example, anxiety, depression, low self-esteem, and others.
The previous list does not contain a complete list of complications. However, you can talk with your doctor about measures to reduce the risk or even prevent the previous complications. Unfortunately, there is no way to prevent ovarian germ cell tumors.
Diagnosis
First, doctors will ask some questions about your medical history and symptoms. They may also perform a physical examination to check for irregularities linked to the disease. However, to identify the location and size of the abnormal growths, doctors often perform the following tests. For example:
- Imagining tests – Usually, doctors begin with a transvaginal ultrasound if they suspect an ovarian germ cell tumor. Thereafter, they may also perform an MRI (magnetic resonance imaging) scan or a CT (computed tomography) scan.
- Blood tests – These are often used to check the levels of alpha-fetoprotein (AFP), lactate dehydrogenase (LDH), or human chorionic gonadotropin (HCG). High levels of these substances may indicate an ovarian germ cell tumor.
Once you are diagnosed with an ovarian germ cell tumor, doctors may perform additional imaging tests, including a PET (positron emission tomography) scan, to determine the extent (stage) of the cancer. It helps make the best treatment plan for you.
Treatment
In most cases, doctors prescribe different treatments for people with ovarian germ cell tumors because they depend on some factors. These include the size, type, and location of the tumor, existing health problems, age, and preferences. Check some options below:
Benign Ovarian Germ Cell Tumors
The primary treatment for people with benign growths is surgery to remove them. Sometimes, doctors may also recommend oophorectomy (the removal of the entire ovary) or ovarian cystectomy (the removal of a part of the ovary only). Moreover, these benign growths rarely return after treatment.
Malignant Ovarian Germ Cell Tumors
- Surgery – Doctors often perform an oophorectomy to remove the affected ovary or fallopian tubes. When the cancer has spread, doctors may recommend a total hysterectomy to remove the uterus and cervix.
- Chemotherapy – This treatment involves strong medicines to destroy cancerous cells throughout the body. While it is usually given to the patients intravenously (IV), a pill form is also available. In some cases, doctors may recommend this cancer treatment before surgery to shrink a large tumor or after surgery to destroy cancer cells that may remain.
Frequently Asked Questions
Is ovarian germ cell cancer curable?
Yes, but in the early stages only, when the tumor is small. However, if the cancer spreads to other parts of the body, it becomes more difficult to treat.
When should I see my healthcare provider about ovarian germ cell tumors?
You should visit a doctor right away if any of the previous symptoms occur. However, it does not cause symptoms in the early stages, which is why doctors recommend regular checkups.
What is the most common germ cell tumor in the ovaries?
Most people develop mature teratomas (also known as dermoid cysts). Usually, these tumors are benign (noncancerous) and occur in their 20s or 30s. If you have additional questions, ask your healthcare provider.
