Female Genital Tract
An ovarian neoplasm in a 14-year old girl is most likely to be: (AIIMS May 2012)
|A||Germ cell tumor|
|C||Sertoli-Leydig cell tumor|
|D||Granulosa cell tumor|
• Epithelial tumors of ovary usually occur in old age
• Germ cell tumors of ovary generally occur in younger women. About 75% of these occur in women <30 years old
• Stromal tumors (like Sertoli Leydig tumors and granulosa cell tumors) occur in all ages.
• Granulosa- theca cell tumors are mostly seen in post- menopausal loomen.
• Sertoli-Leydig cell tumors occur in women of all ages, although the peak incidence is in second and third decade
Thus, we are left with two options: Germ cell tumors and Sertoli Leydig cell tumors. But, if we see the frequency of tumors; germ cell tumors have 15-20% whereas all sex-cord stromal tumors (Sertoli Leydig is one of them) together constitute only 5-10% of ovarian neoplasms
Thus, a 14-year-old girl is most likely to have germ cell tumor.
Important Points About Ovarian Neoplasms
• These may develop from epithelial cells (like serous, mucinous, Brenner tumor etc), germ cells (like granulose cell tumor, Sertoli-Leydig cell tumors etc).
• Most common ovarian neoplasms are epithelial tumors
• Most common malignant ovarian neoplasms are epithelial tumors.
Two types of autosomal dominant familial cancers have been identified:
− Breast/ovarian cancer syndrome: Due to mutations in BRCA1 or BRCA2 genes.
− Lynch type ll syndrome: Results due to mutations in mismatch repair genes. This is associated with Non-polyposis colorectal cancer, endometrial and ovarian cancer.
• CA-125 is marker of epithelial ovarian cancers
• Dysgerminoma is ovarian counterpart of seminoma and is highly sensitive to radiation therapy