Systemic management of malignant ovarian germ cell tumors in older women: two case reports and a review of the literature

Abstract

Background Ovarian germ cell tumors (OGCT) account for 2-5% of ovarian malignancies, with an annual incidence of 0.5-1:100,000, typically occurring in young women. Yolk sac tumor (YST) is the second most common type of OGCT and has an aggressive phenotype. The rarity of this pathology in postmenopausal women poses challenges in the diagnosis and treatment. Patients and Methods We report two clinical cases of YST in postmenopausal women treated at the Royal Marsden and discuss diagnosis and treatment issues of OGCTs in older women. A literature review was also performed, which identified thirty-nine cases, including the two reported in this article. Results and Conclusion This showed that YSTs in older women are rare and are generally aggressive with poor clinical outcomes. Twelve of the described patients with malignant OGCTs died within 8 months of diagnosis. In conclusion, YST in postmenopausal women can have an aggressive disease course compared with younger patients. More evidence for the tolerability and outcomes of cytoreductive surgical approaches and intensive chemotherapy regimens in older patients is required.