Dysgerminoma of the ovary in an adolescent girl associated with a high serum β-human chorionic gonadotropin (β-hCG) level

A 14-year-old girl presented with lower abdominal pain and distension, persisting for three months. Pelvic-abdominal imaging showed a well-defined heterogeneous mass arising from the pelvis, measuring 18×10.5×23 centimetres and contained cystic degenerations. Serum tumour markers, including a beta-sub-unit of human chorionic gonadotropin (β-hCG) and lactate dehydrogenase (LDH), were highly elevated. During a laparotomy, a large right ovarian mass, measuring 20×25 centimetres and weighing more than 1,500 grams with enlarged pelvic and para-aortic lymph nodes, was discovered. A unilateral right salpingo-oophorectomy, an infracolic omentectomy, an ipsilateral lymphadenectomy and an appendectomy were then performed. Histopathologic examination revealed that the dysgerminoma FIGO Stage was IIIC. Immunohistochemical stainings were positive for placental alkaline phosphatase (PALP) and CD117. The patient received four cycles of chemotherapy and had a strict follow-up of computed tomography (CT) scans, providing images with an analysis of tumour markers over the following two years. All the changes were restored to within normal limits without any evidence of recurrence.

Immunohistochemistry; Ovarian dysgerminoma; Tumour markers; Beta-sub-unit of human chorionic gonadotropin (β-hCG)

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