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Recent Advances in the Pathology and Classification of Gonadal Neoplasms Composed of Germ Cells and Sex Cord Derivatives

Talerman, Aleksander M.D.; Roth, Lawrence M. M.D.

International Journal of Gynecological Pathology: July 2007 - Volume 26 - Issue 3 - p 313-321
doi: 10.1097/01.pgp.0000250148.52215.ce
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Summary: In recent years, our understanding of neoplasms composed of germ cells and sex cord derivatives has increased. In this review, advances in the classification and pathology of ovarian germ cell-sex cord-stromal tumors are discussed. Only 2 neoplasms, each with a distinctive pathogenesis and clinicopathologic features, are included in this category. Gonadoblastoma is a tumor that usually occurs in the dysgenetic gonads of intersex patients that have a Y chromosome, whereas mixed germ cell-sex cord-stromal tumor arises in normal gonads in patients without sex chromosomal abnormalities. Ovarian mixed germ cell-sex cord-stromal tumors differ from their testicular counterparts in their histological appearance, immunohistochemical staining reactions, and biological behavior probably because the latter show a greater degree of maturity of their germ cell component. The introduction of cisplatin-based chemotherapy and the application of tumor markers have dramatically improved the clinical outlook for those patients who develop secondary malignant germ cell neoplasms.

From the Departments of Pathology, Thomas Jefferson University, Philadelphia, Pennsylvania and Indiana University School of Medicine, Indianapolis, Indiana.

Address correspondence and reprint requests to Aleksander Talerman, MD, Department of Pathology, Room 285Q, Main Building, Thomas Jefferson University, 11th and Walnut Streets, Philadelphia, PA 19107-5244. E-mail: mtalerman@aol.com

©2007International Society of Gynecological Pathologists