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Malignant Mixed Germ Cell Tumor

Case Detail

Anatomy: Genitourinary
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 10 years ago
Updated: over 9 years ago
Tags: PEDS
Modality/Study Types: MR
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10 year old female with pelvic mass on physical examination.

Case Images


Malignant Mixed Germ Cell Tumor

Clinical Notes

Alpha Fetoprotein – 106,307
Beta hCG – 6

Malignant mixed germ cell tumor (98% yolk sac tumor and 2% dysgerminoma) arising from the right ovary and encasing or adherent to the uterus, adnexae and rectosigmoid portion of colon.


MR – Coronal T1, FS T2 and postgadolinium T1 images demonstrate a large heterogeneous neoplasm with central necrosis.


Mixed germ cell tumor is an example of a “combination” tumor which contains an admixture of more than one germ cell component. Although the imaging findings of mixed germ cell tumors are variable, the possibility of mixed germ cell tumor should be considered when a predominantly solid and heterogeneous ovarian tumor contains fatty areas or when a mature cystic teratoma contains an enhancing solid portion. In some instances, imaging findings of mixed germ cell tumor may be similar to those of malignantly transformed teratomas. Elevation of alpha-fetoprotein and human chorionic gonodotropin levels and a younger patient age can help establish the diagnosis of mixed germ cell tumor.


Park SB, Kim JK, Kim KR, Cho KS. Imaging Findings of Complications and Unusual Manifestations of Ovarian Teratomas. RadioGraphics (2008); 28: 969-983.

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