25 YEARS EXPERIENCE OF CLINICOPATHOLOGICAL PROFILE OF OVARIAN GERM CELL TUMORS IN INDIAN WOMEN AND THE UTILITY OF SALL4 AND OCT3/4 AS A DIAGNOSTIC IMMUNOHISTOCHEMICAL MARKER

Deepshikha Arora, *Ruchi Rathore M. D., Sonal Sharma M. D. and Sarla Agarwal M.D

ABSTRACT

Introduction: Ovarian germ cell tumors (GCT) differ from other ovarian tumors in their histology, age of presentation, prognosis and treatment. Complete knowledge of the Clinicopathological profile of these tumors and proper diagnosis of these neoplasms is essential for appropriate treatment and maintenance of fertility wherever possible. Material and Methods: This is a retrospective study of clinicopathologic profile of all the GCT of ovary received over a period of 25 years. The immunostaining characteristics of two immunohistochemical markers OCT3/4 and SALL4 were studied on 32 cases of malignant GCTs and their sensitivity and specificity for malignant GCTs were compared. Results: 25.7% (284/1102) of all the ovarian tumors were GCTs. Mature cystic teratoma was the most common tumor in our study forming 20.2% of the total ovarian neoplasms. Oct 3/4 displayed 100 percent positivity in dysgerminomas and mixed tumors with dysgerminomatous component but was largely negative in yolk sac tumors and was only focally positive in immature teratomas. SALL4 immunostain results were similar to OCT3/4 in dygerminomas, mixed GCTs and immature teratomas but SALL4 was found to be a far better marker for yolk sac tumors displaying 100 percent positivity with strong intensity. Conclusion: 25.7% (284/1102) of all the ovarian tumors were GCTs in our study. The present study indicates that SALL4 is a better marker than OCT3/4 for diagnosis of malignant GCTs and may fulfill the need for a pan germ cell marker.

Keywords: Germ cell tumor, OCT3/4, SALL4, dysgerminoma, ovary, immature teratoma, yolk sac tumor.