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Jung H, Yun BS, Jung YY, Kim HS. Dissecting Gonadoblastoma of the Ovary Coexistent with an Atypical Endometriotic Cyst: Incidental Detection in Cystectomy Specimen of a Woman with 46,XX Karyotype. Diagnostics (Basel) 2022; 12:diagnostics12030660. [PMID: 35328213 PMCID: PMC8947402 DOI: 10.3390/diagnostics12030660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 11/16/2022] Open
Abstract
Dissecting gonadoblastoma (DGB) of the ovary, a recently described terminology, defines a unique distribution of neoplastic germ cells. Here, we report a case of incidental DGB coexistent with an atypical endometriotic cyst occurring in a 23-year-old woman. The ovarian cyst was lined by endometrial-like glands and stroma. Some glands displayed nuclear enlargement and hyperchromasia, and abundant eosinophilic cytoplasm with occasional intracytoplasmic hemosiderin and mucin vacuoles. The neoplastic germ cells resembled those of ovarian dysgerminoma and were diffusely distributed within the ovarian stroma, which was stretched around the wall of the endometriotic cyst. These cells were arranged in nests and cords, possessing clear cytoplasm and centrally located round nuclei with prominent nucleoli and occasional mitoses. Chromosomal analysis revealed a 46,XX karyotype. We describe the clinical, histological, immunophenotypical, and genetic features of ovarian DGB incidentally detected in the ovarian cystectomy specimen of a woman with normal female karyotype.
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Affiliation(s)
- Hera Jung
- Department of Pathology, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang 10414, Korea;
| | - Bo Seong Yun
- Department of Obstetrics and Gynecology, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang 10414, Korea;
| | - Yoon Yang Jung
- Department of Pathology, Myongji Hospital, Hanyang University College of Medicine, Goyang 10475, Korea
- Correspondence: (Y.Y.J.); (H.-S.K.)
| | - Hyun-Soo Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Correspondence: (Y.Y.J.); (H.-S.K.)
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Gonadoblastoma in individuals with a normal karyotype and no evidence of a disorder of sex development. Pathology 2020; 52:605-607. [PMID: 32616344 DOI: 10.1016/j.pathol.2020.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/19/2020] [Accepted: 04/23/2020] [Indexed: 11/23/2022]
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Arafah MA, Raddaoui LE. Malignant Mixed Germ Cell Tumor Overgrowing a Gonadoblastoma in a Female With a 46, XX Karyotype: A Case Report. Int J Surg Pathol 2017; 26:287-292. [DOI: 10.1177/1066896917744342] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Maria A. Arafah
- King Saud University and King Khaled University Hospital, Riyadh, Kingdom of Saudi Arabia
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Esin S, Baser E, Kucukozkan T, Magden HA. Ovarian gonadoblastoma with dysgerminoma in a 15-year-old girl with 46, XX karyotype: case report and review of the literature. Arch Gynecol Obstet 2011; 285:447-51. [DOI: 10.1007/s00404-011-2073-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 08/16/2011] [Indexed: 12/30/2022]
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The chromosome Y-linked testis-specific protein locus TSPY1 is characteristically present in gonadoblastoma. Hum Pathol 2010; 41:1544-9. [PMID: 20656323 DOI: 10.1016/j.humpath.2010.04.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Revised: 03/31/2010] [Accepted: 04/02/2010] [Indexed: 01/15/2023]
Abstract
Gonadoblastoma is a rare gonadal neoplasm that occurs almost exclusively in individuals who are phenotypically females. Most cases develop in women who have an abnormal karyotype in which at least a portion of the centromeric region of the short arm of chromosome Y is present, a region often referred to as the GBY locus. Of the several genes present in the GBY locus, the TSPY1 gene (which encodes testis-specific protein, a protein thought to have a role in cell cycle regulation) appears to be the most likely to have a critical role in the pathogenesis of gonadoblastoma. To evaluate the association of TSPY1 with the tumor, we developed an interphase fluorescent in situ hybridization assay that uses probes that target the region of the GBY locus that contains TSPY1 and a commercially available chromosome X CEP probe. Using this set of probes in a dual-color approach, we evaluated 6 cases of gonadoblastoma identified from our files and found that both TSPY1 and chromosome X were present in 5 (84%) of 6 cases; in these 5 cases, the adjacent nonneoplastic gonadal parenchyma showed the same genotype as the tumor. Of 6 cases, 1 (16%) showed no evidence of TSPY1; in this case, which occurred in a gravida 2 para 2 woman, 2 X chromosomes were present in the nonneoplastic ovary, the gonadoblastoma, and associated dysgerminoma and granulosa cell tumors. From a basic science perspective, our data demonstrate that the TSPY1 gene is present in most gonadoblastomas, supporting the hypothesized role for TSPY1 in gonadoblastoma tumorigenesis; the lack of TSPY1 in a fertile woman suggests that other loci can, however, substitute for TSPY1 in the development of the tumor. From a clinical perspective, our data show that interphase fluorescence in situ hybridization targeting TSPY1 is a straightforward approach that can be used in the evaluation of Y-associated intersex disorders in women who develop gonadoblastoma.
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Yilmaz B, Gungor T, Bayramoglu H, Soysal S, Mollamahmutoglu L. Bilateral ovarian gonadoblastoma with coexisting dysgerminoma in a girl with 46, XX karyotype. J Obstet Gynaecol Res 2010; 36:697-700. [DOI: 10.1111/j.1447-0756.2010.01225.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kilic-Okman T, Yardim T, Gücer F, Altaner S, Yuce MA. Breast cancer, ovarian gonadoblastoma and cervical cancer in a patient with Peutz-Jeghers Syndrome. Arch Gynecol Obstet 2008; 278:75-7. [PMID: 18193442 DOI: 10.1007/s00404-007-0535-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Accepted: 12/03/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND Peutz-Jeghers Syndrome (PJS) is a rare autosomal dominant disorder characterized by gastrointestinal hamartomatous polyps and mucocutaneous pigmentation. Patients with PJS have increased risk for gastrointestinal, breast, and female genital tract cancers. CASE Multiple genital tract cancers in a 34-year-old woman with PJS are described. The patient, who was admitted to our department with severe vaginal bleeding, was performed right salpingo-oophorectomy because of pure gonadoblastoma in 1996. In 2003, concomitant to cervical carcinoma, breast cancer was diagnosed. Patient underwent left modified radical mastectomy due to the invasive papillary carcinoma. The patient received six cycles combination chemotherapy and radiation therapy because of stage IIIB cervical cancer. CONCLUSION(S) This is the first case report presenting PJS associated with multiple genital tract tumors including ovarian gonadoblastoma in literature. The clinical significance of these tumors in PJS patients has been reviewed.
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Affiliation(s)
- Tulay Kilic-Okman
- Department of Obstetrics and Gynecology, Trakya University Faculty of Medicine, 22030 Edirne, Turkey.
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Jorgensen EV, Steffensen T, Gilbert-Barness E, Nora F, Witt LC. Clinical pathologic correlation: primary amenorrhoea and bilateral adnexal tumors. Fetal Pediatr Pathol 2008; 27:245-58. [PMID: 19065322 DOI: 10.1080/15513810802447920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A case of bilateral gonadoblastoma in 46,XY gonadal dysgenesis is presented and discussed by both clinician and pathologist, in this traditional clinico-pathologic conference. The discussion includes the differential diagnoses of primary amenorrhoea.
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Affiliation(s)
- E Verena Jorgensen
- Department of Pediatrics, University of South Florida College of Medicine, Tampa, Florida, USA
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Talerman A, Roth LM. Recent Advances in the Pathology and Classification of Gonadal Neoplasms Composed of Germ Cells and Sex Cord Derivatives. Int J Gynecol Pathol 2007; 26:313-21. [PMID: 17581418 DOI: 10.1097/01.pgp.0000250148.52215.ce] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In recent years, our understanding of neoplasms composed of germ cells and sex cord derivatives has increased. In this review, advances in the classification and pathology of ovarian germ cell-sex cord-stromal tumors are discussed. Only 2 neoplasms, each with a distinctive pathogenesis and clinicopathologic features, are included in this category. Gonadoblastoma is a tumor that usually occurs in the dysgenetic gonads of intersex patients that have a Y chromosome, whereas mixed germ cell-sex cord-stromal tumor arises in normal gonads in patients without sex chromosomal abnormalities. Ovarian mixed germ cell-sex cord-stromal tumors differ from their testicular counterparts in their histological appearance, immunohistochemical staining reactions, and biological behavior probably because the latter show a greater degree of maturity of their germ cell component. The introduction of cisplatin-based chemotherapy and the application of tumor markers have dramatically improved the clinical outlook for those patients who develop secondary malignant germ cell neoplasms.
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Affiliation(s)
- Aleksander Talerman
- Department of Pathology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107-5244, USA.
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Cooper C, Cooper M, Carter J, Russell P. Gonadoblastoma progressing to dysgerminoma in a 55-year-old woman with normal karyotype. Pathology 2007; 39:284-5. [PMID: 17454768 DOI: 10.1080/00313020701230708] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zhao S, Kato N, Endoh Y, Jin Z, Ajioka Y, Motoyama T. Ovarian gonadoblastoma with mixed germ cell tumor in a woman with 46, XX karyotype and successful pregnancies. Pathol Int 2000; 50:332-5. [PMID: 10849320 DOI: 10.1046/j.1440-1827.2000.01041.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An extremely rare case of unilateral gonadoblastoma with mixed germ cell tumor arising in the ovary of a 27-year-old woman with 46,XX karyotype and two successful pregnancies is reported. The mixed germ cell tumor was composed of choriocarcinoma, embryonal carcinoma, yolk sac tumor, immature teratoma and dysgerminoma. The patient has been well, without evidence of disease for over 10 years since her first surgery and adjuvant chemotherapy.
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Affiliation(s)
- S Zhao
- Department of Pathology, Yamagata University School of Medicine, Yamagata, Japan
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Abstract
Most patients with gonadoblastoma have dysgenetic gonads. This rare tumour has been described in three pregnant women. A fourth case in a 26 year old pregnant woman who presented with gonadoblastoma and dysgerminoma, is reported. She had a normal term pregnancy, 46XX chromosomes, normal genitalia, no history of menstrual irregularities and no signs of hyperandrogenism, thereby differing from the other reported cases. The germ cell component of this patient's tumour had undergone rapid overgrowth, most of the tumour comprising pure dysgerminoma. It is suggested that gonadoblastoma may occur in functionally and morphologically normal gonads more often than previous case reports imply.
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Affiliation(s)
- Y Erhan
- Obstetrics and Gynaecology Department, Ege University Medical Faculty, Bornova, Turkey
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14
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Affiliation(s)
- J L Rutgers
- Department of Pathology, Harbor-UCLA Medical Center, Torrance 90509
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Nakashima N, Nagasaka T, Fukata S, Oiwa N, Nara Y, Fukatsu T, Takeuchi J. Study of ovarian tumors treated at Nagoya University Hospital, 1965-1988. Gynecol Oncol 1990; 37:103-11. [PMID: 2323605 DOI: 10.1016/0090-8258(90)90317-e] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The relative frequency and the age distribution of ovarian tumors (873 primary and 47 secondary tumors) encountered over 23 years at Nagoya University Hospital were examined with respect to histological type and grade of malignancy. Of the primary neoplasms, common epithelial tumors accounted for 56.6%, sex cord-stromal tumors for 7.3%, and germ cell tumors for 39.5%. Among 296 cases with primary malignant neoplasms, common epithelial type accounted for 75.6%, sex cord-stromal tumors for 4.7%, and germ cell tumors for 19.6%. A review of the literature from Western countries indicated that in Japan, the relative frequency of common epithelial tumors is lower but that of germ cell tumors, especially malignant germ cell tumors, is higher. The difference in the incidence of germ cell tumors between Japan and Western countries is not considered significant, and the incidence of common epithelial tumors is considered to be much lower in Japan.
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Affiliation(s)
- N Nakashima
- Department of Laboratory Medicine, Nagoya University School of Medicine, Japan
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