Endodermal sinus tumor and embryonal carcinoma of the ovary in a 53-year-old woman.
BACKGROUND
Germ cell tumors, the most common ovarian malignancies in females under the age of 21, are rare in older women. We report an unusual case of a mixed embryonal carcinoma and endodermal sinus germ cell tumor in a perimenopausal patient and review the differential diagnosis and management of these malignancies with respect to age.


METHODS
A 53-year-old woman complaining of irregular menses and pelvic pain was found to have a large pelvic mass and a positive pregnancy test. Subsequent investigation revealed a large left adnexal mass, and an elevated beta-HCG and alpha-AFP. At laparotomy, a mixed germ cell tumor was found. The patient was treated with multiagent chemotherapy and currently is without evidence of disease.


CONCLUSIONS
Although rare, the diagnosis of germ cell tumor should be considered in older women presenting with a large pelvic mass. The treatment and prognosis is similar regardless of age, except that reproductive-sparing surgery is not a priority in the older patient.
Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque 87131, USA.
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Kammerer-Doak
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Baurick
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Black
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DM
Barbo
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Smith
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D018236:Carcinoma, Embryonal / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D002945:Cisplatin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D018240:Endodermal Sinus Tumor / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D018237:Germinoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin