Dysgerminoma : Treatment
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Treatment: Given that dysgerminomas occur in young patients in whom the preservation of fertility is important, the treatment usually consists of unilateral salpingo-oophorectomy. If the contralateral ovary is grossly normal, it is not biopsied so as not to increase the risk of infertility. Monitoring in the follow-up period consists of imaging studies and serum tumor marker levels (LDH, AFP, and beta-hCG). For recurrent or metastatic tumors, cisplatin-based chemotherapy (bleomycin, etoposide, cisplatin) is recommended. Dysgerminomas are highly sensitive to radiation; however, there has been move away from radiotherapy lately in an effort to preserve fertility.
Patients who develop dysgerminoma in the setting of gonadal dysgenesis and a Y chromosome should undergo bilateral oophorectomy. In an older patient where fertility is not a factor, the treatment consists of hysterectomy with bilateral salpingo-oophorectomy. This is followed by cisplatin-based chemotherapy for high stage tumors.
The image shows a focus of necrosis in a dysgerminoma.
Patients who develop dysgerminoma in the setting of gonadal dysgenesis and a Y chromosome should undergo bilateral oophorectomy. In an older patient where fertility is not a factor, the treatment consists of hysterectomy with bilateral salpingo-oophorectomy. This is followed by cisplatin-based chemotherapy for high stage tumors.
The image shows a focus of necrosis in a dysgerminoma.