Ovarian Germ Cell Tumor

Ovarian germ cell tumors develop from reproductive cells (also called germ cells) in your ovaries. These tumors usually grow in one ovary. Women and people assigned female at birth who are under age 20 get these tumors most often, but people can get them later in life, too.

Cancerous ovarian germ cell tumors are rare. Most of them are benign. Ovarian dermoid cysts (mature teratomas) are the most common benign ovarian germ cell tumors.

Cancerous ovarian germ cell tumors include:

• Dysgerminoma: The most common malignant ovarian germ cell tumor.
• Immature ovarian teratoma: Can spread (metastasize) to other areas of your body.
• Endodermal sinus tumor (yolk sac tumor): Grows quickly and usually affects children and younger people assigned female at birth.

Ovarian germ cell tumors often grow silently. So you may not notice symptoms right away. But as these tumors grow, you may have a swollen belly (abdomen), cramping and pelvic pain or tenderness. You might feel queasy or constipated. And, in rare instances, you might have bleeding between periods or after menopause (post-menopausal).

What to expect at your first visit

Often, your gynecologist or primary care provider finds an ovarian growth during your annual exam. Or maybe you noticed something wasn’t quite right on your own.

At your first appointment, we’ll start by getting to know you. We’ll ask you to tell us your story in your own words, so we can better understand what you’re experiencing. We’ll ask questions, too, like:

• Are you having any symptoms?
• How long have you had symptoms?
• Are they getting worse?
• How are these symptoms affecting your life?

We’ll also go over your personal and family health histories. Then, we’ll do a pelvic exam to check for abdominal growths and a Pap smear (Pap test) to check for abnormal cells in your cervix. We may also decide to order other tests.

Blood tests

Blood samples let us check the levels of certain substances in your blood (tumor markers). These levels may be higher if you have a germ cell tumor. We may do:

• CA-125 test.
• Testing for tumor markers, Inhibin A and Inhibin B.
• Alpha-fetoprotein (AFP) test.
• Human chorionic gonadotropin (HCG).
• Lactate dehydrogenase (LDH) test.

Imaging tests

These tests let our providers see detailed views of your ovaries and look for cysts or tumors. You may have:

• A CT scan.
• An MRI.
• A pelvic ultrasound.
• A PET scan.
• A transvaginal ultrasound.

Biopsy

Our experts may do a laparoscopy to look at your ovaries and remove tissue samples to test for cancer (biopsy). If the ovarian germ cell tumors are malignant, a biopsy helps our experts stage the cancer and decide how best to treat you.

Second Opinions for Ovarian Germ Cell Tumors

Finding out you may have ovarian germ cell tumors can be overwhelming. It’s important to feel confident that you’re working with a team of healthcare providers you trust completely. That’s why we encourage second opinions.

Our expert cancer specialists will take the time to help you better understand what’s going on and explain what your treatment options are. We also know that cancer doesn’t wait, so we always try to get your appointment with us scheduled as soon as possible. A second opinion can give you peace of mind knowing that you’re in the most capable and compassionate hands.

Meet Our Ovarian Germ Cell Tumors Team

If you choose to come to Cleveland Clinic, you’ll get a team of expert healthcare providers from different specialties. All of them work together to confirm your diagnosis so they can craft the most personalized treatment plan for your needs. Your team could include:

• Gynecologists.
• Gynecological and radiation oncologists.
• Gynecological surgeons.
• Pathologists.
• Radiologists.
• Nurse practitioners.
• Physician assistants.

If your test results show that your ovarian germ cell tumor is cancerous, your care team will consider the location and stage of the tumor when planning your care. We work together — and with you — to create a custom treatment plan that matches your needs. Your treatment could include:

Surgery

When possible, our gynecologic surgeons use laparoscopic surgery and robotic surgery to treat most ovarian germ cell tumors — benign or malignant. These minimally invasive procedures use tiny incisions instead of one large one, so you’ll have less scaring and recover faster. Depending on the size and type of tumor, you may have:

• Partial oophorectomy.
• Total oophorectomy.
• Tumor debulking (removing as much of the tumor as possible).

If the ovarian germ cell tumor is malignant and has spread outside your ovary, we may do a total hysterectomy.

Chemotherapy and radiation

After surgery, we may treat you with chemotherapy (chemo) to destroy cancer cells or stop them from growing. You may have treatments for several weeks or months. It all depends on how large your tumor is and if it’s spread. We may also recommend radiation therapy after surgery.

Follow-up care

Because ovarian germ cell tumors can come back, you may need follow-up testing after treatment. Your providers will talk with you about what to expect once treatment is done.

Taking the Next Step

If symptoms have you feeling uneasy (and not quite yourself), don’t put off making a call to your healthcare provider. Our gynecological experts can pinpoint what’s causing you to feel bad and start treatment right away. If you have an ovarian germ cell tumor, we’ll guide you through every step with expert care and compassionate support.