Ovarian germ cell tumors (OGCTs) are heterogeneous tumors that are derived from the primitive germ cells of the embryonic gonad, which accounts for about 2.6% of all ovarian malignancies. There are four main types of OGCTs, namely dysgerminomas, yolk sac tumor, teratoma, and choriocarcinoma.. Dygerminomas are Malignant germ cell tumor of ovary and particularly prominent in patients diagnosed with gonadal dysgenesis. OGCTs are relatively difficult to detect and diagnose at an early stage because of the nonspecific histological characteristics. Common symptoms of OGCT are bloating, abdominal distention, ascites, and dyspareunia. OGCT is caused mainly due to the formation of malignant cancer cells in the primordial germ cells of the ovary. The exact pathogenesis of OGCTs is still unknown however, various genetic mutations and environmental factors have been identified. OGCTs are commonly found during pregnancy when an adnexal mass is found during a pelvic examination, ultrasound scans show a solid mass in ovary or blood serum test shows elevated alpha-fetoprotein levels. They are unlikely to have metastasized and therefore the standard tumor management is surgical resection, coupled with chemotherapy. The occurrence rate is less than 3% worldwide. The preliminary diagnosis begins with a pelvic examination, serum tumor marker test and imaging. Physicians may feel a large palpable mass or lump in lower abdomen upon insertion of the gloved fingers into the vagina. To further identify the histologic subtypes of OGMTs, blood samples of patients are collected to analyse the serum level of biomarkers released by the tumor cells. A surge in the plasma levels of human chorionic gonadotropin and alpha-fetoprotein is indicative of OGMTs. Lactate dehydrogenase, alkaline phosphatase and cancer antigen 125 might potentially increase as well. To visualize the location and morphology of the tumor, transvaginal ultrasonography is usually employed. The most characteristic appearance is a parenchymal-like heteroechoic mass with sharp borders and high vascularization. Computed tomography would produce stacked image inside the peritoneal region of the body to visualise the lobular pattern of the tumour. Usually for dysgerminoma, solid mass being compartmentalized into lobules with enhancing septa may be evident for haemorrhage or necrosis.

Malignant OGCTs are predominantly unilateral and chemosensitive, which means they are localized in only one side of the ovary. Fertility-preserving surgery is primarily standardized to keep the contralateral ovary and fallopian tube intact, also known as unilateral salpingo-oophorectomy. For Stage II patients with observable metastasis, cytoreductive surgery may be performed to debulk the volume of the tumor, such as hysterectomy (removal of all or part of the uterus) and bilateral salpingo-oophorectomy. A surgical incision at the abdominal cavity after the completion of adjuvant chemotherapy, called second look laparotomy, is best applicable for patients reported with teratomatous elements after previous cytoreductive surgery.

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