Ovarian mixed germ cell tumor. A case report

Background: Ovarian mixed germ cell tumors (OMGCT) are rare, comprising 1.7 to 5.3% of all malignant ovarian germ cell tumors. These tumors typically affect adolescent women of reproductive age, presenting as large, solid unilateral masses. This case report details an 8-year-old female from Cabricán, Quetzaltenango, who was diagnosed with a mixed germ cell tumor. Initially evaluated for nausea and vomiting, a palpable mass was detected in her hypogastric region. Imaging and laboratory tests revealed elevated lactate dehydrogenase (LDH), alkaline phosphatase (ALP), alpha-fetoprotein (AFP), and beta-human chorionic gonadotropin (β-hCG). OMGCTs arise from primitive germ cells and account for 25% of all ovarian tumors, though only 5% are malignant. These tumors often manifest as large, rapidly growing masses that may be asymptomatic or present with abdominal distension, pain, or other symptoms. Ultrasound is the first imaging modality used to evaluate them, while CT and MRI provide further evaluation, particularly of tumor extent and complications. In mixed germ cell tumors, imaging shows large, solid masses with cystic degeneration, and MRI is helpful in detecting necrosis or hemorrhage. Serum markers, particularly AFP and β-hCG, are crucial for diagnosis. Treatment typically involves unilateral salpingo-oophorectomy, with more aggressive options, including chemotherapy, considered based on tumor spread and metastasis. Proper diagnosis relies on integrating imaging, serum markers, and histopathological findings. Keywords: Ovarian tumor, Germ cell tumor.