Extraovarian Dysgerminoma Involving the Uterine Cervix: A Rare Case Report With Literature Review

Int J Gynecol Pathol. 2023 Nov 1;42(6):544-549. doi: 10.1097/PGP.0000000000000928. Epub 2023 Aug 14.

Abstract

Primary extraovarian dysgerminoma (EOD) is a very rare disease. There is no literature about primary EOD involving the uterine cervix. We herein present details of a unique case of primary EOD involving the uterine cervix. A 46-year-old woman with uterine cervical tumor was referred to our institution with atypical genital bleeding. A polypoid tumor localized to the uterine cervix was found. Cervical biopsy detected malignant components of likely nonepithelial cell origin. Preoperative imaging examinations showed a uterine cervical tumor measuring ~5 cm, suggestive of malignancy without distant or lymph node metastases. The patient underwent abdominal radical hysterectomy with pelvic lymph node dissection according to the standard treatment for stage IB3 cervical cancers. The pathological diagnosis was dysgerminoma involving the uterine cervix and the right fallopian tube. Immunohistochemical results were as follows: SALL4 (+), octamer-binding transcription factor 4 (+), D2-40 (+), and c-Kit (+). She received 3 cycles of adjuvant chemotherapy with bleomycin, etoposide, and cisplatin. The disease did not recur up to 14 months after surgery. This is the first-ever published case of primary EOD involving the uterine cervix among previously reported EOD cases. Reported cases of EOD in female genital tract are also reviewed. Our case provides more extensive insights for pathologists to consider the differential diagnosis of cervical lesions. In our case, combination therapy involving a surgical approach-according to cervical cancers and adjuvant chemotherapy as used for ovarian dysgerminomas-was effective. Future verification is needed regarding the best approach for treating uterine cervical dysgerminomas.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Dysgerminoma* / diagnosis
  • Dysgerminoma* / surgery
  • Female
  • Humans
  • Hysterectomy
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Ovarian Neoplasms* / diagnosis
  • Ovarian Neoplasms* / surgery
  • Uterine Cervical Neoplasms* / pathology