title: Unclassified mixed germ cell-sex cord-stromal tumor with multiple malignant cellular elements in a young woman: a case report and review of the literature.
abstract: Unclassified mixed germ cell-sex cord-stromal tumor composed of germ cells and sex cord derivatives is a rare neoplasm. Approximately 10% of such tumors have malignant germ cell components. We report the case of a 28 year-old female with a right adnexal mass measuring 8 cm in greatest dimension, containing areas with both germ cell and sex cord components. The germ cell portion contained multiple growth patterns with a malignant appearance, while the sex cord element consisted mainly of annular tubules. Within the malignant germ cell elements was a dysgerminoma that accounted for approximately 75% of the tumor volume. Other malignant germ cell elements included yolk sac tumor, embryonal carcinoma, and choriocarcinoma, which comprised about 15% of the tumor volume. The annular tubule structures comprised about 10% of the total tumor volume. To our knowledge, this is the first case reported in the literature of an unclassified mixed germ cell-sex cord-stromal tumor associated with embryonal carcinoma components. The patient had a 46XX karyotype, regular menstrual periods, and no evidence of gross abnormalities in the contralateral ovary. The patient remained clinically well and disease-free 2 years after surgery. In addition to a thorough case description, the literature concerning this entity is reviewed and discussed.
authors.affiliation: Department of Pathology, Tianjin Central Hospital of Gynecology Obstetrics Tianjin, China.
authors.forename: Shujie
authors.initials: S
authors.lastname: Pang
authors.affiliation: Department of Pathology, Tianjin Central Hospital of Gynecology Obstetrics Tianjin, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Tianjin Central Hospital of Gynecology Obstetrics Tianjin, China.
authors.forename: Yiquan
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Pathology, Tianjin Central Hospital of Gynecology Obstetrics Tianjin, China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000473:pathology*; D018312:Sex Cord-Gonadal Stromal Tumors / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor
keywords: Mixed germ cell-sex cord-stromal tumor; gonadoblastoma; mixed malignant germ cell tumor; sex cord tumors with annular tubules