What is dysgerminoma and how does it compare with seminoma (seminoma is a type of testicular cancer, also known as germinoma)?

From the Guidelines

Dysgerminoma and seminoma are both germ cell tumors that are histologically identical but occur in different sexes, with dysgerminoma being a malignant ovarian germ cell tumor and seminoma being the testicular equivalent. Dysgerminoma typically affects young women, often in their teens or twenties, while seminoma occurs in men, usually between ages 30-40. Both tumors arise from primitive germ cells and share similar microscopic appearances, with sheets of uniform cells containing clear cytoplasm, distinct cell borders, and centrally located nuclei. They also express similar tumor markers, including placental alkaline phosphatase (PLAP) and OCT3/4, as noted in studies such as 1. However, dysgerminomas may occasionally produce low levels of human chorionic gonadotropin (hCG), while pure seminomas typically do not, as discussed in 1. Both tumors are highly sensitive to radiation and platinum-based chemotherapy, with excellent prognosis when treated appropriately, with the 5-year survival rate exceeding 95% for early-stage disease in both cases, as reported in 1. Some key points to consider in the management of these tumors include:

• Treatment typically involves surgery followed by chemotherapy for advanced stages, with fertility preservation being an important consideration, especially in young patients, as emphasized in 1.
• The use of chemotherapy, such as bleomycin/etoposide/cisplatin (BEP), is recommended for certain stages of dysgerminoma and seminoma, as outlined in 1 and 1.
• Radiation therapy may also be used in certain cases, although its use is associated with an increased risk of late toxicities, including secondary malignancies, as noted in 1.
• The management approaches for dysgerminoma and seminoma may differ slightly due to anatomical differences and the distinct clinical contexts in which these tumors present, as discussed in 1 and 1. Overall, the management of dysgerminoma and seminoma requires a multidisciplinary approach, taking into account the individual patient's needs and circumstances, as well as the latest evidence-based guidelines, such as those provided in 1 and 1.

From the Research

Definition of Dysgerminoma

• Dysgerminoma is a rare malignant tumor composed of germ cells, originally from the embryonic gonads 2.
• It occurs at a fertile age and is typically treated with surgical removal of the tumor, followed by preservation of fertility 2.

Comparison with Seminoma

• Dysgerminomas of the ovary and seminomas of the testis are analogous diseases, with seminomas having a 10-fold higher incidence 3.
• The two tumors are morphologically identical and share genetic features, including KIT and RAS mutations, amplification of chromosome 12p, and expression of pluripotency markers 3.
• Both histologies are exquisitely sensitive to platinum chemotherapy, with the combination of bleomycin, etoposide, and cisplatin (BEP) yielding survival rates greater than 90% 3, 4, 5.

Treatment and Outcomes

• The BEP regimen has been shown to be safe and effective in patients with ovarian germ cell tumors, including dysgerminoma 4, 5.
• Treatment with vinblastine, actinomycin D, bleomycin, cyclophosphamide, and cis-platinum has also been effective in advanced germ cell testis tumors, including seminoma 6.
• De-escalation of chemotherapy treatment is being considered, with proposals for future trials to enroll men, women, and children to benefit all patients regardless of age or sex 3.