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» Articles » PMID: 36817070

Dysgerminoma Masquerading As Gestational Trophoblastic Neoplasia

Overview
Journal Case Rep Obstet Gynecol
Publisher Wiley
Specialty Gynecology & Obstetrics
Date 2023 Feb 23
PMID 36817070
Authors
Conner Blackwell
Shian McLeish
David Iglesias
Shannon D Armbruster
Affiliations
Soon will be listed here.
Abstract

Background: Persistent elevation in beta-human chorionic gonadotropin (-hCG) following a pregnancy is concerning for gestational trophoblastic neoplasia (GTN). However, the differential diagnosis should remain broad during the evaluation process.

Case: A 34-year-old G3P3 presented with elevated -hCG four months after cesarean delivery with bilateral tubal ligation. The patient was treated with methotrexate for a presumed new ectopic pregnancy. Due to persistent -hCG elevation, she received actinomycin-D for GTN treatment. After completing chemotherapy, her -hCG increased. The patient underwent a laparoscopic hysterectomy with unplanned left oophorectomy due to its nodular appearance at the time of surgery. Pathology confirmed a dysgerminoma of the ovary and benign uterus.

Conclusion: Although dysgerminomas are uncommon, they should be considered when -hCG levels remain elevated despite therapies for more common pathologies.

References
1.
Braga A, Mora P, de Melo A, Nogueira-Rodrigues A, Amim-Junior J, Rezende-Filho J . Challenges in the diagnosis and treatment of gestational trophoblastic neoplasia worldwide. World J Clin Oncol. 2019; 10(2):28-37. PMC: 6390119. DOI: 10.5306/wjco.v10.i2.28. View
2.
Seckl M, Sebire N, Fisher R, Golfier F, Massuger L, Sessa C . Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013; 24 Suppl 6:vi39-50. DOI: 10.1093/annonc/mdt345. View
3.
Zhao S, Sun F, Bao L, Chu C, Li H, Yin Q . Pure dysgerminoma of the ovary: CT and MRI features with pathological correlation in 13 tumors. J Ovarian Res. 2020; 13(1):71. PMC: 7301981. DOI: 10.1186/s13048-020-00674-z. View
4.
Guerriero S, Testa A, Timmerman D, Van Holsbeke C, Ajossa S, Fischerova D . Imaging of gynecological disease (6): clinical and ultrasound characteristics of ovarian dysgerminoma. Ultrasound Obstet Gynecol. 2011; 37(5):596-602. DOI: 10.1002/uog.8958. View
5.
Nasioudis D, Mastroyannis S, Latif N, Ko E . Trends in the surgical management of malignant ovarian germcell tumors. Gynecol Oncol. 2020; 157(1):89-93. DOI: 10.1016/j.ygyno.2020.01.033. View