Ovarian germ cell tumor is a disease in which malignant (cancer) cells form in the germ (egg) cells of the ovary.
Germ cell tumors begin in the reproductive cells (egg or sperm) of the body. Ovarian germ cell tumors usually occur in teenage girls or young women and most often affect just one ovary.
The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries produce eggs and female hormones (chemicals that control the way certain cells or organs function).
Ovarian germ cell tumor is a general name that is used to describe several different types of cancer. The most common ovarian germ cell tumor is called dysgerminoma. (Refer to the PDQ summaries on Ovarian Epithelial Cancer Treatment and Ovarian Low Malignant Potential Tumors Treatment for information about other types of ovarian cancers.)
Possible signs of ovarian germ cell tumor are swelling of the abdomen or vaginal bleeding after menopause.
Ovarian germ cell tumors can be difficult to diagnose (find) early. Often there are no symptoms in the early stages, but tumors may be found during regular gynecologic examinations (checkups). A woman who has swelling of the abdomen without weight gain in other places should see a doctor. A woman who no longer has menstrual periods (who has gone through menopause) should also see a doctor if she has bleeding from the vagina.
Tests that examine the ovaries, pelvic area, blood, and ovarian tissue are used to detect (find) and diagnose ovarian germ cell tumor.
The following tests and procedures may be used:
Certain factors affect prognosis (chance of recovery and treatment options).
The prognosis (chance of recovery) and treatment options depend on the following:
Ovarian germ cell tumors are generally curable if found and treated early.
After ovarian germ cell tumor has been diagnosed, tests are done to find out if cancer cells have spread within the ovary or to other parts of the body.
The process used to find out whether cancer has spread within the ovary or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Certain tests are used in the staging process.
Many of the tests used to diagnose ovarian germ cell tumor are also used to determine the stage of the disease. Unless a doctor is sure the cancer has spread from the ovaries to other parts of the body, surgery is required to determine the stage of cancer in an operation called a laparotomy. The doctor must cut into the abdomen and carefully look at all the organs to see if they contain cancer. The doctor will cut out small pieces of tissue and look at them under a microscope to see whether they contain cancer. The doctor may also wash the abdominal cavity with fluid and then look at the fluid under a microscope to see if it contains cancer cells. Usually the doctor will remove the cancer and other organs that contain cancer during the laparotomy.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for ovarian germ cell tumors:
Stage I
In stage I, cancer is found in one or both of the ovaries and has not spread. Stage I is divided into stage IA, stage IB, and stage IC.
Stage II
In stage II, cancer is found in one or both ovaries and has spread into other areas of the pelvis. Stage II is divided into stage IIA, stage IIB, and stage IIC.
Stage III
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In stage III, cancer is found in one or both ovaries and has spread to other parts of the abdomen. Stage III is divided into stage IIIA, stage IIIB, and stage IIIC as follows:
Cancer that has spread to the surface of the liver is also considered stage III disease.
Stage IV
In stage IV, cancer is found in one or both ovaries and has metastasized (spread) beyond the abdomen to other parts of the body.
Cancer that has spread to tissues in the liver is also considered stage IV disease.
Recurrent ovarian germ cell tumor is cancer that has recurred (come back) after it has been treated. The cancer may come back in the other ovary or in other parts of the body.
There are different types of treatment for patients with ovarian germ cell tumors.
Different types of treatment are available for patients with ovarian germ cell tumor. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Three types of standard treatment are used:
Surgery
Surgery is the most common treatment of ovarian germ cell tumor. A doctor may take out the cancer using one of the following types of surgery.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Even if the doctor removes all the cancer that can be seen at the time of the operation, some patients may be offered chemotherapy or radiation after surgery to kill any cancer cells that are left. Treatment given after the surgery to increase the chances of a cure is called adjuvant therapy.
Following radiation or chemotherapy, an operation called a second-look laparotomy is sometimes done. This is similar to the laparotomy that is done to determine the stage of the cancer. During the second-look operation, the doctor will take samples of lymph nodes and other tissues in the abdomen to see if any cancer is left.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.
High-dose chemotherapy with bone marrow transplant
High-dose chemotherapy with bone marrow transplant is a method of giving very high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body’s blood cells.
New treatment options
Combination chemotherapy (the use of more than one chemotherapy drug to fight cancer) is being tested in clinical trials.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.
Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.
Treatment of dysgerminoma may include the following:
Treatment of other germ cell tumors may be either:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I ovarian germ cell tumor.
Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.
Treatment of dysgerminoma may be either:
Treatment of other germ cell tumors may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II ovarian germ cell tumor.
Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.
Treatment of dysgerminoma may include the following:
Treatment of other germ cell tumors may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III ovarian germ cell tumor.
Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.
Treatment of dysgerminoma may include the following:
Treatment of other germ cell tumors may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV ovarian germ cell tumor.
Treatment depends on whether the tumor is dysgerminoma or another type of germ cell tumor.
Treatment of dysgerminoma may be:
Treatment of other germ cell tumors may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent ovarian germ cell tumor.
For more information from the National Cancer Institute about ovarian germ cell tumors, see the Ovarian Cancer Home Page.
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The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
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Last Modified: 2008-09-12