Successful Management of Ultra-high-risk Mixed Ovarian Germ Cell Tumor Using a Pediatric-inspired Intensive Chemotherapy Regimen: A Case Report.
Juhun Lee, Hyun Jung Lee, Seung Ho Song et al.
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Case in brief
A 33-year-old woman presented with acute hemoperitoneum and was found to have FIGO stage IVB mixed malignant ovarian germ cell tumor comprising 60% dysgerminoma, 40% choriocarcinoma, and focal yolk sac tumor. After optimal cytoreductive surgery, a multidisciplinary team selected a dose-dense, modified cyclophosphamide, bleomycin, etoposide, cisplatin, and methotrexate regimen every 2 weeks, drawing on pediatric oncology approaches. She tolerated seven cycles, achieved complete remission, and remained progression-free for 3 years at the time reported.
What made this case unusual
The tumor combined a predominant choriocarcinomatous component with other germ cell elements and presented with acute hemoperitoneum. Management used a pediatric-inspired, dose-dense regimen for this ultra-high-risk adult case.
Diagnostic / clinical pearl
In a mixed ovarian germ cell tumor with a substantial choriocarcinomatous component, pathology should establish the component proportions and stage; this case illustrates multidisciplinary consideration of an intensified regimen after cytoreductive surgery.