August 2021 · Volume 10 · Issue 8 Page 3197 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Ayadi MA et al. Int J Reprod Contracept Obstet Gynecol. 2021 Aug;10(8):3197-3203 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Case Series Pure dysgerminoma of the ovary: a study of 31 cases Hasna Salhi 1 *, Mohamed Ali Ayadi 2 , Imen Bouraoui 2 , Riadh Chargui 2 , Khaled Rahal 2 INTRODUCTION Malignant ovarian germ cell tumors are a rare form of gonadal malignancy that are most prevalent in adolescents and young adults. The most common type of these tumors is dysgerminoma that accounts for 38.2% of germ cells tumors and for 3 to 5% of all primary ovarian malignancies. 1 Dysgerminomas can be pure or mixed being one of several components of a germ cell tumor such as malignant teratoma or choriocarcinoma. 2 It is derived from primordial germ cells of the sexually undifferentiated embryonic gonad and affects predominantly younger women being less than 30 years old. 3 Nearly 50% of dysgerminomas occur before the age of 20 but they are rare before the age of 10. 3 The majority of dysgerminomas are diagnosed at an early stage with unilateral involvement affecting one ovary that’s why they respond well to conservative fertility- sparing treatment consisting of unilateral salpingo- oophorectomy. The oncologic safety of this procedure was confirmed for an early -stage disease and is currently the gold standard. 4 Ovarian dysgerminomas, like their male counterpart the seminoma, are extremely radio- and chemo sensitive, therefore an excellent prognosis is usually expected and they are generally considered of low-grade malignancy but they may spread. 3 CASE SERIES Thirty-one patients were found to have a pure dysgerminoma of ovary between 1970 and 2012 and are the subject of this study. Patients with dysgerminoma combined with other germ cell tumors were excluded. DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20212980 1 Department of Surgical Oncology, Regional Hospital of Siliana, Tunisia 2 Department of Surgical Oncology, Salah Azaiez Institute, Tunisia Received: 02 June 2021 Revised: 05 July 2021 Accepted: 06 July 2021 *Correspondence: Dr. Hasna Salhi, E-mail: hasna.salhi@yahoo.fr Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Malignant germ cell tumors of the ovary are rare tumors characterized by their heterogeneity and occurring mostly in young women. Dysgerminoma is the most common type of these tumors. This was a retrospective study of 31 patients with pure dysgerminoma of the ovary diagnosed in Salah Azaiez institute of Tunis in Tunisia between 1970 and 2012. The median age was 22 years old. Abdominal pain was the most complaint in 45.1% of cases. An abdomino-pelvic mass was found in 83.8% of cases. Surgery was performed in all patients. The median tumoral size was 13.7 cm. Sixty four-point five percent of the patients underwent a conservative surgery. The tumor was classified stage I in 51.6% of the cases, stage II in 9.7% of the cases, stage III in 35.5% of the cases and stage IV in 3.2% of the cases. Fourteen patients received platinum-based adjuvant chemotherapy, and 10 patients had a radiotherapy. We have noticed 2 cases of recurrence and 2 cases of metastasis. Five-year and ten-year overall survival was 89.4%. Five-year disease free survival was 85.2% and ten-year disease free survival was 66.3%. Dysgerminomas of the ovary have a good prognosis. The two significant prognostic factors are the stage and the postoperative residual disease. Keywords: Ovary, Germ cell, Tumor, Malignant, Dysgerminoma