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Abstract

Ovarian germ cell tumors and sex cord stromal tumors

These kinds of tumors constitute two heterogenous but rare groups of tumors which are most commonly seen in adolescents and young women,respectively. If treated according to current standards ovarian germ cell tumors are highly curable at all stages of disease. Appropriate surgical staging is the mainstay of treatment and fertility sparing surgery is possible in most patients with early stage disease. In patients with advanced stage disease optimal cytoreductive surgery without postoperative macroscopic residual tumor appears to be beneficial.The introduction of platinum based adjuvant chemotherapy represents a breakthrough in clinical management with cure rates approaching 100% for patients with early stage disease. Controversy exists on the selection of patients who can safely undergo surveillance without adjuvant chemotherapy. The majority of sex cord-stromal tumors are of low malignant potential and are associated with a favourable long term prognosis.The clinical presentation is frequently governed by manifestations resulting from excessive estrogen production. Sex cord-stromal tumors with a potential fatal course include granulosa-cell tumors, poorly differentiated Sertoli-Leydig cell tumors and steroid-cell tumors not otherwise specified which require comprehensive surgical staging and adjuvant platinum based chemotherapy should be considered.

Keywords
Germ cell tumors, sex cord stromal tumors, ovarian neoplasia, dysgerminoma, granulosa cell tumors

Christian Kurzeder
Universitätsfrauenklinik Ulm
Reviewer: Werner Meier, Düsseldorf
und Annette Hasenburg, Freiburg

CME Pratk Fortbild Gynakol Geburtsmed Gynakol
Endokrinol 2008; 4(2): 150-162