[Germinal cell tumors in young and adolescent girls].
OBJECTIVE
Germ cell tumours are the most common ovarian tumours in childhood and adolescence. This diverse group of tumours derives from germ cells.


METHODS
The aim of this work is presentation of germ cell tumours in the material from our clinic with characteristic clinical features, the scope of operation and effects of many years of observation.


METHODS
We treated 109 girls with germ cell tumours of the ovary: 13 had malignant tumours: there were 7 patients with dysgerminomas, 2 with endodermal sinus tumour of the ovary, 3 with immature teratomas, 1 with carcinoma embryonale. Gonadoblastomas was diagnosed 4 patients and mature teratomas in 92 patients.


RESULTS
11 patient had gonadal dysgenesia with abnormal karyotype. These girls had no follicle apparatus in gonads and had elevated levels of gonadotropins. Gonadoblastoma is almost always found in patients with gonadal dysgenesis. Gonadoblastoma often produces estradiol or testosterone. There can be problems with diagnosis of the syndrome, because developmental features imitate the onset of normal puberty. Most patients with dysgerminoma have stage I of disease and surgery is sufficient. It must be suggested that patients of stage I who wish to preserve childbearing function may be treated with unilateral salpingoophorectomy and adjuvant chemotherapy. Monitoring of the treatment is connected with measurement of biochemical markers. Some of these markers are useful for monitoring of response to therapy. When levels of markers are low second look laparoscopic operation should be performed. Cytological smears and biopsy specimens from the remaining ovary, peritoneum and subdiaphragmatic area should be obtained laparoscopically.


CONCLUSIONS
The sift ultrasonographic investigations can be helpful in the early diagnosis of germ cell tumours of the ovary in girls. Absence of follicle apparatus in the gonads requires determination of levels of gonadotropins and karyotype. Fertility sparing operative treatment is preferred when karyotype is normal.
Rzepka-Górska
Izabella
I
Katedry i Kliniki Ginekologii Operacyjnej i Onkologii Ginekologicznej Dorosłych i Dziewczat PAM w Szczecinie.
Błogowska
Anna
A
Zajaczek
Stanisław
S
Zielińska
Dorota
D
D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D002648:Child; D003131:Combined Modality Therapy; D004407:Dysgerminoma / Q000473:pathology / Q000628:therapy; D018240:Endodermal Sinus Tumor / Q000473:pathology / Q000628:therapy; D005260:Female; D018237:Germinoma / Q000473:pathology / Q000628:therapy; D018238:Gonadoblastoma / Q000473:pathology / Q000628:therapy; D006062:Gonadotropins / Q000097:blood / Q000235:genetics; D006801:Humans; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology* / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy*; D011044:Poland; D012307:Risk Factors; D013724:Teratoma / Q000473:pathology / Q000628:therapy
D014408:Biomarkers, Tumor; D006062:Gonadotropins