Ovarian dysgerminoma: a case report and literature review

A 27-year-old nulligravida active duty U.S. Navy chief petty officer presented with right flank pain and recurrent urinary tract infections without any history of nocturnal sweating or unexplained weight loss. Her physical examination was remarkable for mild right costovertebral angle tenderness and urinalysis showed hematuria. Subsequent computed tomography urolithiasis protocol revealed a 5 × 13 × 7 cm right pelvic mass. Further evaluation of the mass with magnetic resonance imaging revealed a solid, enhancing right ovarian mass and para-aortic lymphadenopathy; additional samples were drawn demonstrating elevated serum lactate dehydrogenase, suggestive of malignancy. Dysgerminoma was suspected and subsequent salpingo-oophorectomy and lymph node biopsies confirmed the diagnosis. The prevalence, common presentation, diagnosis, clinical course, and prognosis--with specific attention to cooperative management of this patient in many aspects of military medicine: primary care, gynecology, oncology, and radiology--were explored.