Dysgerminoma: a study of 13 cases from the Connecticut Tumor Registry

Thirteen cases of patients with dysgerminoma of the ovary, accrued from the Connecticut Tumor Registry from 1974-84, were reviewed. Seven of the 13 patients were stage I at the time of initial surgery. Two of these patients had a diagnosis of dysgerminoma arising within a gonadoblastoma. Five of the seven patients were treated with some form of adnexal surgery; one patient received adjuvant combination chemotherapy consisting of vincristine, dactinomycin, and cyclophosphamide (VAC) and another received radiation therapy. Two of the seven patients were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH/BSO) plus radiation therapy. One patient, whose tumor recurred after initial therapy with unilateral oophorectomy, was successfully treated with radiation therapy. Six patients had advanced disease at the time of initial surgery. One patient with stage II disease and three patients with stage III disease were treated with TAH/BSO plus radiation therapy. One patient with stage III disease was treated with unilateral adnexectomy plus combination chemotherapy consisting of vinblastine, bleomycin, dactinomycin, cyclophosphamide, and cisplatin (VAB-VI). One patient with stage IV disease was treated with decompressive laminectomy with tumor resection, removal of left pelvic mass, radiation therapy and adjuvant combination chemotherapy (VAC). In our series, no patient died from dysgerminoma (one patient died of an apparently unrelated cause). The role of radiation therapy in the treatment of advanced and recurrent dysgerminoma has been demonstrated. However, the use of combination chemotherapy has been playing an increasingly important role in patients treated with conservative surgery in which preservation of fertility is a concern.