Clinicopathological Characteristics and Histological Patterns of Gonadal Germ Cell Tumors: A Retrospective Comparative Study

Background: Gonadal germ cell tumours comprise a diverse group of neoplasms with marked differences in their age distribution, histological patterns and biological behaviour. Accurate pathological classification is important because treatment and prognosis depend on the anatomical site, histological subtype, tumour stage and presence of mixed components. Material and Methods: This retrospective comparative study included all histologically confirmed primary ovarian and testicular germ cell tumours diagnosed at the Department of Pathology, Madurai Medical College and Government Rajaji Hospital, Madurai, between July 2012 and August 2014. Clinical details, radiological findings, serum tumour markers, gross characteristics and histopathological features were reviewed. Routine haematoxylin and eosin-stained sections were examined, and immunohistochemistry using CD117, CD30, alpha-fetoprotein, beta-human chorionic gonadotropin and CD45 was performed in selected diagnostically difficult cases. Results: A total of 54 gonadal germ cell tumours were included, comprising 42 ovarian tumours (77.8%) and 12 testicular tumours (22.2%). The highest frequency occurred in the 20–29-year age group. Mature teratoma was the most common ovarian tumour, accounting for 36 cases (85.7%). The remaining ovarian tumours included three yolk sac tumours and one case each of dysgerminoma, grade 3 immature teratoma and gonadoblastoma associated with choriocarcinoma. Conclusion: Ovarian and testicular germ cell tumours demonstrate distinct clinicopathological patterns. Ovarian tumours are predominantly benign mature teratomas, while testicular tumours are mainly malignant, with seminoma and mixed germ cell tumour being the leading subtypes.

Keywords: Gonadal germ cell tumour; ovarian germ cell tumour; testicular germ cell tumour; mature teratoma; seminoma; mixed germ cell tumour; immunohistochemistry.