title: Ovarian malignant mixed germ cell tumor with clear cell carcinoma in a postmenopausal woman.
abstract: Malignant germ cell tumors of the ovary are very rare and account for about 2-5% of all ovarian tumors of germ origin. Most patients are adolescent and young women, approximately two-thirds of them are under 20 years of age, occasionally in postmenopausal women. But clear cell carcinoma usually occurs in older patients (median age: 57-year old), and closely related with endometriosis. Here we report a case of a 55-year old woman with right ovarian mass that discovered by B ultrasonic. Her serum levels of human chorionic gonadotropin (hCG) and α-fetoprotein (AFP) were elevated. Pathological examination revealed the tumor to be a mixed germ cell tumor (yolk sac tumor, embryonal carcinoma and mature teratoma) with clear cell carcinoma in a background of endometriosis. Immunohistochemical staining showed SALL4 and PLAP were positive in germ cell tumor area, hCG, CD30 and OCT4 were positive in epithelial-like cells and giant synctiotrophoblastic cells, AFP, AAT, CD117 and Glyp3 were positive in yolk sac component, EMA and CK7 were positive in clear cell carcinoma, CD10 was positive in endometrial cells of endometriotic area. She was treated with surgery followed by seven courses of chemotherapy. She is well and serum levels of hCG and AFP have been decreased to normal levels.
authors: Department of Pathology, Tianjin Central Hospital of Gynecology and Obstetrics Tianjin, China.
authors: Xiu-Jie
authors: XJ
authors: Yu
authors: Department of Pathology, Tianjin Central Hospital of Gynecology and Obstetrics Tianjin, China.
authors: Lin
authors: L
authors: Zhang
authors: Department of Pathology and Laboratory Medicine, Dalhousie University Halifax, Nova Scoria, Canada.
authors: Zai-Ping
authors: ZP
authors: Liu
authors: Department of Pathology, Tianjin Central Hospital of Gynecology and Obstetrics Tianjin, China.
authors: Yi-Quan
authors: YQ
authors: Shi
authors: Department of Pathology, Tianjin Central Hospital of Gynecology and Obstetrics Tianjin, China.
authors: Yi-Xin
authors: YX
authors: Liu
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D018236:Carcinoma, Embryonal / Q000097:blood / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D006063:Chorionic Gonadotropin / Q000097:blood; D018240:Endodermal Sinus Tumor / Q000097:blood / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D004715:Endometriosis / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D018193:Neoplasms, Complex and Mixed / Q000097:blood / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000097:blood / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D017698:Postmenopause; D013724:Teratoma / Q000097:blood / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D016896:Treatment Outcome; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C097353:AFP protein, human; D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins
keywords: Mixed germ cell tumor; clear cell carcinoma; ovary