Clinical Features of Malignant Ovarian Germ Cell Tumors According to Demographic and Pathologic Characteristics

Background and Aims: Malignant ovarian germ cell tumors (MOGCTs) are aggressive cancers affecting mainly young women, in whom fertility preservation is important. Diagnosis is often delayed because early symptoms are non-specific, leading to advanced disease or emergency surgery that may limit optimal staging and fertility-sparing treatment. As no effective screening exists and early detection improves survival, increased symptom awareness is essential. This study describes the demographic and clinical characteristics of MOGCTs to support earlier diagnosis. Methods: The present study is a descriptive-analytical cohort study conducted at Vali-ASR Hospital in Tehran, Iran, from 2001 to 2018. Patients with malignant ovarian tumors were evaluated with respect to demographic characteristics, obstetric and medical history, pathological findings, and clinical signs and symptoms before and at the time of diagnosis. The duration of symptoms was also recorded. Data was analyzed using SPSS version 24, employing descriptive statistical methods. Results: The mean age of MOGCT cases (128 ones) was 23.88 ± 7.85 years. We found abdominal distension (45%) followed by acute pain (40.95%), chronic pain (23.95%), menstrual irregularity (14.7%), sense of abdominal firmness and mass (7.72%), nausea (5.4%), fever (5.4%), lack of apatite (4.63%), virilization (3.1%), and depletion of weight (3.1%). Abdominal distension and pain, acute or chronic, and menstrual disorders were the most common symptoms in all patients, but their incidence declined along with aging. The percentage of abdominal distention, ascites, and menstrual disorders in parous women was less than that of nullipara. Conclusion: MOGCTs present a significant diagnostic challenge due to their nonspecific and often misinterpreted symptoms, which vary notably by histologic subtype. Our findings emphasize that a high index of suspicion, coupled with an understanding of this symptom variability, is crucial for the timely diagnosis and improved management of these aggressive tumors, particularly in young women.