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Patterns of presentation and outcomes of germ cell tumours in women in Oman

L Almutawea, M Al Kalbani, R Lakhtakia, I Burney
Published in : HAMDAN MEDICAL JOURNAL ; Vol 8, No 4 (2015): Supplement Issue
DOI : 10.7707/hmj.502

Abstract


Introduction: Germ cell tumours of the ovary arise from three germ cell layers: the ectoderm, the endoderm and the mesoderm. These tumours are classified as benign or malignant and can be unilateral or bilateral. Malignant tumours may present with metastases, but respond to chemotherapy and have a good overall prognosis.

Objectives: To study the clinical and pathological patterns of germ cell tumours and treatment outcomes at a single tertiary referral centre in Oman.

Materials and methods: Consecutive adult patients treated for germ cell tumours at Sultan Qaboos University Hospital, Muscat, over the study period from January 2011 to June 2014 were the subject of this study. Data were extracted from electronic health records and entered into pre-designed questionnaires. Data were collected on demographic features, presenting symptoms, signs, laboratory investigations, radiological patterns of involvement, treatment and outcomes of treatment. Analysis was carried out using SPSS (Statistical Product and Service Solutions) version 19.0 (IBM Corporation, Armonk, NY, USA) and survival analysis was explored using the Kaplan– Meier method.

Results: A total of 70 patients were identified. Sixty (86%) were benign mature teratomas and 66% of patients had left unilateral ovarian involvement. Sixty-six per cent of patients presented with abdominal discomfort. The remaining 10 cases were malignant and the most common subtypes were immature teratoma and choriocarcinoma. Ten patients had high lactate dehydrogenase levels and nine had a high beta-human chorionic gonadotropin levels. Only four patients had elevated alpha-fetoprotein. The primary management for all the benign tumours was surgery. Malignant germ cell tumours were treated either with an initial surgery (n =9) or with combination chemotherapy (n =7). The 2-year survival rate was 65%.

Conclusions: The vast majority of germ cell tumours were benign, and were treated with fertility-sparing surgery. The overall survival of the malignant tumours was excellent.

 


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