Dysgerminoma with syncytiotrophoblastic giant cells presenting as a hydatidiform mole

There have been a total of 11 cases of pure dysgerminoma with syncytiotrophoblastic giant cells (SGC) previously reported in the literature as of June 1981. All were Stage IA, all were treated with unilateral salpingo-oophorectomy, and the preoperative serum human chorionic beta-gonadotropin (beta-hCG) titers ranged from 2000 to 3160 mlU/ml. A recent case at William Beaumont Army Medical Center involved a 20-year-old Hispanic female who presented with a 20 weeks' size pelvic-abdominal mass which was sonographically consistent with a hydatidiform mole. An initial preoperative serum beta subunit hCG was 193,000 mlU/ml. At the time of surgery a Stage IC dysgerminoma of the right ovary was discovered and right salpingo-oophorectomy performed. In reviewing all 11 previously reported cases, not only is this case the first Stage IC reported, but it also is the first to present as a hydatidiform mole, has the highest ever reported preoperative beta-hCG, and provides the first ultrastructural study of this tumor type. The unusual clinical presentation and management of this case are discussed and a brief review of the clinical and pathological features of this unusual tumor is given.