Youth Cancer

Ovarian Germ Cell Tumour

A germ cell tumour of the ovary is called an ovarian teratoma. It only affects females as the ovaries are female reproductive organs.

  • Every woman has two ovaries, one on either side of the womb. The ovaries produce eggs and female hormones (oestrogen and progesterone), which make menstruation (periods) and pregnancy possible.
  • Each month, in women of childbearing age, one ovary produces an egg. The egg passes down the fallopian tube to the womb (uterus). If the egg is not fertilised by a sperm it passes out of the womb as part of the monthly period.
  • Most ovarian cancers are a type called epithelial cancer. A germ cell tumour is slightly different than a typical ovarian cancer as it starts in the egg producing part of the ovary. Germ cell tumours tend to affect only one ovary, and most are curable even if diagnosed at an advanced stage.

 

Types of Germ Cell Tumours

There are three types:

  • Dermoid cysts: Benign tumours, commonest type of germ cell tumour, seen in young women.
  • Dysgerminomas: Mostly affects women in their twenties, a malignant tumour, can be in both ovaries.
  • Non-dysgerminomatous germ cell tumours: Mostly diagnosed in girls or young women. Malignant and usually affect only one ovary.

There are a number of different types of non-dysgerminomatous germ cell tumours:

  • yolk sac tumours
  • immature teratoma
  • mixed primitive germ cell tumours
  • choriocarcinoma gonadoblastoma
  • embryonal carcinoma


What causes an Ovarian Germ Cell Tumopurs?

The causes are unknown.
 

What are the symptoms?

Common symptoms include:

  • Abdominal pain
  • Feeling of fullness
  • Abdominal swelling
  • Irregular vaginal bleeding


Remember: If you have any of these symptoms you should have them checked by your doctor - but remember, they are common to many illnesses.
 

How is it Diagnosed?

After visiting a GP a referral will most probably be made to a hospital for some further tests. These may include:

  • Internal pelvic examination.
  • Ultrasound scan: Apart from regular ultrasounds, scans can also be carried out vaginally. A small device (tampon sized) is inserted, producing sound waves that are converted into an examinable picture.
  • Blood test: A test to see if 'tumour markers' (chemicals) from the tumours are being released into the bloodstream. The two main markers produced are AFP (alpha feta protein) and HCG (human chorionic gonadotrophin).
  • Laparoscopy: A small incision in the skin of the abdomen is made which allowing the doctor to look at the ovaries and the surrounding area with a laparoscope (a small telescope). The doctor can then make a decision whether or not to remove an ovary or ovaries.

 For more information check out our Tests page.

If the results of the test show an ovarian teratoma another referral will be made to a doctor who specialises in the treatment of reproductive germ cell tumours.
 

Staging

The stage of a cancer is a term used to describe its size and whether it has spread beyond where it started in the body. It includes:

  • Stage 1: Cancer only affects the ovaries.
  • Stage 2: Cancer has begun to spread outside the ovaries within the pelvis.
  • Stage 3: Cancer has spread beyond the pelvis to the lining of the abdomen and/or to lymph nodes in the abdomen, or the upper part of the bowel.
  • Stage 4: Cancer has spread to other parts of the body such as the liver, lungs, or distant lymph nodes.


How is it treated?

Fact: With the treatment advancements being made, most women can now be completely cured.

A team of doctors and other staff at the hospital will plan the treatment. It will depend on the size of the tumour and where it is. Treatment may be coordinated by a surgeon, an oncologist (a doctor who specialises in treating cancer with chemotherapy) and a radiologist (a doctor who specialises in treating cancer with radiation).

Treatment may involve:

  • Surgery
  • Chemotherapy
  • Radiotherapy

Surgery for ovarian teratoma

Surgery is generally the first part of the treatment for an ovarian teratoma. This may involve the removal of the affected ovary and fallopian tube through a laparotomy.

Sometimes it may be necessary to remove both ovaries, the fallopian tubes, and the womb (a total abdominal hysterectomy and bilateral salpingo-oophorectomy). If this type of surgery is required, then you need to talk to your doctor about your potential fertility options in the future.

For more information check out our surgery fact sheet.
 

Chemotherapy for ovarian teratoma

Ovarian teratomas are usually sensitive to chemotherapy. Often a combination of chemotherapy drugs is given and sometimes it is not necessary to follow the surgery with chemotherapy if the tumour is completely removed.

For more information check out our chemotherapy fact sheet.


Radiotherapy for ovarian teratoma

Radiotherapy is often used as treatment for ovarian teratomas but it depends on the type.

For more information check out our radiotherapy fact sheet.