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Advanced Ovarian Dysgerminoma Infiltrating Both Ovaries and Uterus in a 7-Year-Old Girl

DOI: 10.1155/2014/910852

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Abstract:

Introduction. Ovarian dysgerminoma is a rare malignant ovarian germ cell tumor with its peak incidence in young women. Abdominal pain, abdominal distention, and the presence of a palpable mass are common symptoms at presentation. Depending on the FIGO stage at presentation the prognosis of dysgerminomas after surgical treatment, adjuvant chemotherapy, and radiotherapy is promising. Case Presentation. A 7-year-old girl was presented at our clinic with abdominal pain in all abdominal quadrants. Later the pain localized in the region of her right ovary. CT scan revealed a massive formation which was connected to her right ovary. Conclusion. Although malignant ovarian germ cell tumours are rare in children, physicians must always consider the possibility of MOGT-occurrences. The clinical symptoms might not be specific: abdominal pain, abdominal distention, nausea, and vomiting. In order to make a correct diagnosis the patients should undergo a complete clinical examination including radiological scans. Initial management is frequently surgery, followed by adjuvant chemotherapy and radiotherapy. Although disgerminoma is malignant tumor, the prognosis is promising. 1. Introduction Dysgerminoma is a rare malignant ovarian germ cell tumor (MOGT) which is highly malignant and has its peak incidence in young women. Approximately one-third of all dysgerminomas show KIT mutations and these are associated with advanced stage at presentation [1]. Clinically the patients present with abdominal pain, abdominal distention, and presence of a palpable mass, reduced appetite, vomiting, and nausea as well as ovarian torsion [2, 3]. Conservative surgery, postoperative chemotherapy, and postoperative radiotherapy are effective therapeutic options. Fertility-preservation surgery is often possible [3] and the overall survival is 92.4% [4]. Preoperative elevation of tumor markers is significantly related to poor prognosis for progression-free survival (PFS) [4]. Dysgerminomas reveal in 28% of cases presence of lymph node metastasis, which is significantly associated with lower 5-year survival (82.8%) [5]. Older patients were more likely to be diagnosed at an advanced stage [6]. 2. Case Presentation We report the case of a 7-year-old Albanian girl who was presented with abdominal pain and a palpable mass in the region of her right ovary. Initially the girl complained about abdominal pain in all quadrants of the abdomen. Later the pain was localized on the right side. According to her mother the pregnancy with her daughter was uncomplicated; the girl had never been ill before, had

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