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{{Ovarian germ cell tumor}}
{{Ovarian germ cell tumor}}
{{CMG}}{{AE}}
{{CMG}}; {{AE}} {{Sahar}} {{MD}}
==Overview==
==Overview==
In USA, the age-adjusted [[incidence]] of [[malignant]] [[ovarian]] [[germ cell]] [[tumor]] is 0.41 per 100,000 women. [[Incidence]] of these [[tumors]] increases from 5 years of age, although it may be present during [[infancy]], and this increase continues to peak between the age of 15 to 19 years which is approximately 1.2 per 100,000 women. Another peak [[incidence]] of these [[tumors]] has been reported among those aged 65 years old or older where [[teratoma]] is the most common type observed. The [[incidence]] is higher among non-white [[Ethnicity and health|ethnicity]] (other than black, especially Hispanic and Asians) followed by white and black individuals. Females are more commonly affected by [[germ cell]] [[tumors]] than males. These [[tumors]] also account for a greater proportion of [[ovarian]] [[tumors]] in the Asia and Africa.
==Epidemiology ==
===Incidence===
*The [[malignant]] [[ovarian]] [[germ cell]] [[tumors]] [[incidence]] increses from 5 years of age, although it may be presnt during [[infancy]], and this increase continues to peak between the age of 15 to 19 years which is approximately 1.2 per 100,000 women.<ref name="QuirkNatarajan2005">{{cite journal|last1=Quirk|first1=Jeffrey T.|last2=Natarajan|first2=Nachimuthu|last3=Mettlin|first3=Curtis J.|title=Age-specific ovarian cancer incidence rate patterns in the United States|journal=Gynecologic Oncology|volume=99|issue=1|year=2005|pages=248–250|issn=00908258|doi=10.1016/j.ygyno.2005.06.052}}</ref><ref name="pmid12752232">{{cite journal |vauthors=Møller H, Evans H |title=Epidemiology of gonadal germ cell cancer in males and females |journal=APMIS |volume=111 |issue=1 |pages=43–6; discussion 46–8 |date=January 2003 |pmid=12752232 |doi= |url=}}</ref><ref name="pmid1645564">{{cite journal |vauthors=dos Santos Silva I, Swerdlow AJ |title=Ovarian germ cell malignancies in England: epidemiological parallels with testicular cancer |journal=Br. J. Cancer |volume=63 |issue=5 |pages=814–8 |date=May 1991 |pmid=1645564 |pmc=1972374 |doi= |url=}}</ref>
*In USA, the age-adjusted  [[incidence]] of  [[malignant]] [[ovarian]] [[germ cell]] [[tumor]] is 0.41 per 100,000 women.<ref name="PectasidesPectasides2008">{{cite journal|last1=Pectasides|first1=D.|last2=Pectasides|first2=E.|last3=Kassanos|first3=D.|title=Germ cell tumors of the ovary|journal=Cancer Treatment Reviews|volume=34|issue=5|year=2008|pages=427–441|issn=03057372|doi=10.1016/j.ctrv.2008.02.002}}</ref>
*These [[tumors]] are less common than [[ovarian]] [[epithelial]] [[tumors]].


==Epidemiology and Demographics==
{| class="wikitable"
===Incidence===
|+
===Mature teratoma===
! colspan="2" |Incidence of Ovarian germ cell tumors
*The incidence of mature/benign teratoma is between 1.2 to 14.2 cases per 100,000 individuals worldwide.<ref name="pmid3166898">{{cite journal |vauthors=Westhoff C, Pike M, Vessey M |title=Benign ovarian teratomas: a population-based case-control study |journal=Br. J. Cancer |volume=58 |issue=1 |pages=93–8 |date=July 1988 |pmid=3166898 |pmc=2246492 |doi= |url=}}</ref>
|-
*The germ cell tumors of the ovary consist approximately one-fourth of ovarian neoplasms and a great majority of them are benign.
|Mature teratoma
|
*The [[incidence]] of mature/[[benign]] teratoma is between 1.2 to 14.2 cases per 100,000 individuals worldwide.<ref name="pmid3166898">{{cite journal |vauthors=Westhoff C, Pike M, Vessey M |title=Benign ovarian teratomas: a population-based case-control study |journal=Br. J. Cancer |volume=58 |issue=1 |pages=93–8 |date=July 1988 |pmid=3166898 |pmc=2246492 |doi= |url=}}</ref>
*The [[germ cell]] [[tumors]] of the [[ovary]] consist approximately one-fourth of [[ovarian]] [[neoplasms]] and a great majority of them are [[benign]].
|-
|Dysgerminoma
|
*Age-adjusted [[incidence]] of this [[tumor]] is 0.109 per 100,000 women-year.<ref name="SmithBerwick2006">{{cite journal|last1=Smith|first1=Harriet O.|last2=Berwick|first2=Marianne|last3=Verschraegen|first3=Claire F.|last4=Wiggins|first4=Charles|last5=Lansing|first5=Letitia|last6=Muller|first6=Carolyn Y.|last7=Qualls|first7=Clifford R.|title=Incidence and Survival Rates for Female Malignant Germ Cell Tumors|journal=Obstetrics & Gynecology|volume=107|issue=5|year=2006|pages=1075–1085|issn=0029-7844|doi=10.1097/01.AOG.0000216004.22588.ce}}</ref>
*The [[incidence]] is greater in those with partial or complete [[gonadal dysgenesis]].<ref name="ShaabanRezvani2014">{{cite journal|last1=Shaaban|first1=Akram M.|last2=Rezvani|first2=Maryam|last3=Elsayes|first3=Khaled M.|last4=Baskin|first4=Henry|last5=Mourad|first5=Amr|last6=Foster|first6=Bryan R.|last7=Jarboe|first7=Elke A.|last8=Menias|first8=Christine O.|title=Ovarian Malignant Germ Cell Tumors: Cellular Classification and Clinical and Imaging Features|journal=RadioGraphics|volume=34|issue=3|year=2014|pages=777–801|issn=0271-5333|doi=10.1148/rg.343130067}}</ref>
|-
|Yolk sac tumor
|Age-adjusted [[incidence]] of this [[tumor]] is 0.048 per 100,000 women-year.<ref name="SmithBerwick2006" />
|-
|Embryonal carcinoma
|Age-adjusted [[incidence]] of this [[tumor]] is 0.014 per 100,000 women-year.<ref name="SmithBerwick2006" />
|-
|Choriocarcinom
|Age-adjusted [[incidence]] of this [[tumor]] is 0.008 per 100,000 women-year.<ref name="SmithBerwick2006" />
|}


===Prevalence===
===Prevalence===
===Mature teratoma===
{| class="wikitable"
*Mature teratoma is the most common ovarian germ cell tumor tumor and accounts for 95% of ovarian teratomas.<ref name="Ulbright2005">{{cite journal|last1=Ulbright|first1=Thomas M|title=Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues|journal=Modern Pathology|volume=18|year=2005|pages=S61–S79|issn=0893-3952|doi=10.1038/modpathol.3800310}}</ref>
|+
* The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
! colspan="2" |Prevalence of Ovarian germ cell tumors
* In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
|-
* The prevalence of [disease/malignancy] is estimated to be [number] cases annually.
|Mature teratoma
 
|Mature teratoma is the most common [[Ovary|ovarian]] [[germ cell]] [[tumor]] and accounts for 95% of [[ovarian]] teratomas.<ref name="Ulbright2005">{{cite journal|last1=Ulbright|first1=Thomas M|title=Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues|journal=Modern Pathology|volume=18|year=2005|pages=S61–S79|issn=0893-3952|doi=10.1038/modpathol.3800310}}</ref>
===Case-fatality rate/Mortality rate===
|-
*In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
|Dysgerminoma
*The case-fatality rate/mortality rate of [disease name] is approximately [number range].
|
*Dysgerminoma is the second most common [[ovarian]] [[germ cell]] [[tumor]].<ref name="Ulbright2005" />
*This [[tumor]] accounts for less than 1% of all [[ovarian]] [[cancers]].<ref name="VicusBeiner2010">{{cite journal|last1=Vicus|first1=Danielle|last2=Beiner|first2=Mario E.|last3=Klachook|first3=Shany|last4=Le|first4=Lisa W.|last5=Laframboise|first5=Stephane|last6=Mackay|first6=Helen|title=Pure dysgerminoma of the ovary 35 years on: A single institutional experience|journal=Gynecologic Oncology|volume=117|issue=1|year=2010|pages=23–26|issn=00908258|doi=10.1016/j.ygyno.2009.12.024}}</ref>
|-
|Mixed germ cell tumor
|
* These [[tumors]] accounts for 10% to 20% of [[malignant]] [[ovarian]] [[germ cell]] [[tumors]] and are the forth most common [[tumors]]. <ref name="Tewari2000">{{cite journal|last1=Tewari|first1=K|title=Malignant germ cell tumors of the ovary|journal=Obstetrics & Gynecology|volume=95|issue=1|year=2000|pages=128–133|issn=00297844|doi=10.1016/S0029-7844(99)00470-6}}</ref>
* The majority of them contain yolk sac [[tumor]] as one of the elements.
|-
|Embryonal carcinoma
|These [[tumors]] are very rare, comprising only 1% of [[ovarian]] [[Germ cells|germ cell]] [[tumors]], and usually are a component of mixed [[germ cell]] [[tumors]].<ref name="ChengZhang2010">{{cite journal|last1=Cheng|first1=Liang|last2=Zhang|first2=Shaobo|last3=Talerman|first3=Aleksander|last4=Roth|first4=Lawrence M.|title=Morphologic, immunohistochemical, and fluorescence in situ hybridization study of ovarian embryonal carcinoma with comparison to solid variant of yolk sac tumor and immature teratoma|journal=Human Pathology|volume=41|issue=5|year=2010|pages=716–723|issn=00468177|doi=10.1016/j.humpath.2009.10.016}}</ref>
|-
|Endodermal sinus tumor
|The pure form of these [[tumors]] are the third most common [[ovarian]] [[tumors]].<ref name="Tewari2000" />
|-
|Non-gestational choriocarcinoma
|These [[Tumor|tumors]] comprised less than 1% of [[malignant]] [[ovarian]] [[germ cell]] [[tumors]].<ref name="JiaoXiang2010">{{cite journal|last1=Jiao|first1=Lan-zhou|last2=Xiang|first2=Yang|last3=Feng|first3=Feng-zhi|last4=Wan|first4=Xi-run|last5=Zhao|first5=Jun|last6=Cui|first6=Quan-cai|last7=Yang|first7=Xiu-yu|title=Clinical Analysis of 21 Cases of Nongestational Ovarian Choriocarcinoma|journal=International Journal of Gynecological Cancer|volume=20|issue=2|year=2010|pages=299–302|issn=1048-891X|doi=10.1111/IGC.0b013e3181cc2526}}</ref>
|}


==Demographics==
===Age===
===Age===
Mature teratoma
*Although The [[malignant]] [[germ cell]] [[tumors]] may be present during the [[infancy]], the has been reported between the age of 15 and 19 years where [[dysgerminoma]] is the most common type observed.<ref name="QuirkNatarajan2005">{{cite journal|last1=Quirk|first1=Jeffrey T.|last2=Natarajan|first2=Nachimuthu|last3=Mettlin|first3=Curtis J.|title=Age-specific ovarian cancer incidence rate patterns in the United States|journal=Gynecologic Oncology|volume=99|issue=1|year=2005|pages=248–250|issn=00908258|doi=10.1016/j.ygyno.2005.06.052}}</ref><ref name="pmid12752232">{{cite journal |vauthors=Møller H, Evans H |title=Epidemiology of gonadal germ cell cancer in males and females |journal=APMIS |volume=111 |issue=1 |pages=43–6; discussion 46–8 |date=January 2003 |pmid=12752232 |doi= |url=}}</ref><ref name="pmid1645564">{{cite journal |vauthors=dos Santos Silva I, Swerdlow AJ |title=Ovarian germ cell malignancies in England: epidemiological parallels with testicular cancer |journal=Br. J. Cancer |volume=63 |issue=5 |pages=814–8 |date=May 1991 |pmid=1645564 |pmc=1972374 |doi= |url=}}</ref>
*Patients of all age groups may develop mature teratoma. However, they tend to present between 20 to 30 years of age at a greater extent.<ref name="Yayla AbideBostancı Ergen2018">{{cite journal|last1=Yayla Abide|first1=Çiğdem|last2=Bostancı Ergen|first2=Evrim|title=Retrospective analysis of mature cystic teratomas in a single center and review of the literature|journal=Journal of Turkish Society of Obstetric and Gynecology|volume=15|issue=2|year=2018|pages=95–98|issn=1307699X|doi=10.4274/tjod.86244}}</ref>
*In USA the age-adjusted  [[incidence]] of  [[malignant]] [[ovarian]] [[germ cell]] [[tumor]] is 0.41 per 100,000 women.<ref name="PectasidesPectasides2008">{{cite journal|last1=Pectasides|first1=D.|last2=Pectasides|first2=E.|last3=Kassanos|first3=D.|title=Germ cell tumors of the ovary|journal=Cancer Treatment Reviews|volume=34|issue=5|year=2008|pages=427–441|issn=03057372|doi=10.1016/j.ctrv.2008.02.002}}</ref>
*The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
*In those who are aged 9 years old or younger, the [[incidence]] has been reported to be 0.1 per 100,000 girls.<ref name="BrookfieldCheung2009">{{cite journal|last1=Brookfield|first1=Kathleen F.|last2=Cheung|first2=Michael C.|last3=Koniaris|first3=Leonidas G.|last4=Sola|first4=Juan E.|last5=Fischer|first5=Anne C.|title=A Population-Based Analysis of 1037 Malignant Ovarian Tumors in the Pediatric Population|journal=Journal of Surgical Research|volume=156|issue=1|year=2009|pages=45–49|issn=00224804|doi=10.1016/j.jss.2009.03.069}}</ref>
*[Disease name] commonly affects individuals younger than/older than [number of years] years of age.  
*In those between the age of 10 to 19 years old, the [[incidence]] has been reported to be 1.1 per 100,000 girls.
*[Chronic disease name] is usually first diagnosed among [age group].
*Another peak [[incidence]] of these [[tumors]] has been reported among those aged 65 years old or older where [[teratoma]] is the most common type observed.<ref name="pmid1645564">{{cite journal |vauthors=dos Santos Silva I, Swerdlow AJ |title=Ovarian germ cell malignancies in England: epidemiological parallels with testicular cancer |journal=Br. J. Cancer |volume=63 |issue=5 |pages=814–8 |date=May 1991 |pmid=1645564 |pmc=1972374 |doi= |url=}}</ref>
*[Acute disease name] commonly affects [age group].
{| class="wikitable"
|+
! colspan="2" |Age
|-
|Mature teratoma
|Patients of all age groups may develop mature teratoma. However, they tend to present between 20 to 30 years of age at a greater extent.<ref name="Yayla AbideBostancı Ergen2018">{{cite journal|last1=Yayla Abide|first1=Çiğdem|last2=Bostancı Ergen|first2=Evrim|title=Retrospective analysis of mature cystic teratomas in a single center and review of the literature|journal=Journal of Turkish Society of Obstetric and Gynecology|volume=15|issue=2|year=2018|pages=95–98|issn=1307699X|doi=10.4274/tjod.86244}}</ref>
|-
|Immature teratoma
|Immature teratoma tends to affect younger patient than mature teratomas (usually the first 2 decades of life).<ref name="OutwaterSiegelman2001">{{cite journal|last1=Outwater|first1=Eric K.|last2=Siegelman|first2=Evan S.|last3=Hunt|first3=Jennifer L.|title=Ovarian Teratomas: Tumor Types and Imaging Characteristics|journal=RadioGraphics|volume=21|issue=2|year=2001|pages=475–490|issn=0271-5333|doi=10.1148/radiographics.21.2.g01mr09475}}</ref>
|-
|Dysgerminoma
|
*Dysgerminoma commonly affects individuals younger than 30 years of age in 85% of cases.<ref name="VicusBeiner2010" />
*The median age at the time of [[diagnosis]] is approximately 19 to 23 years, although it may happen at any age.<ref name="AL HusainiSoudy2012">{{cite journal|last1=AL Husaini|first1=Hamed|last2=Soudy|first2=Hussein|last3=Darwish|first3=Alaa El Din|last4=Ahmed|first4=Mohamed|last5=Eltigani|first5=Amin|last6=AL Mubarak|first6=Mustafa|last7=Sabaa|first7=Amal Abu|last8=Edesa|first8=Wael|last9=AL-Tweigeri|first9=Taher|last10=Al-Badawi|first10=Ismail A.|title=Pure dysgerminoma of the ovary: a single institutional experience of 65 patients|journal=Medical Oncology|volume=29|issue=4|year=2012|pages=2944–2948|issn=1357-0560|doi=10.1007/s12032-012-0194-z}}</ref>
*The tumor is uncommon prepubertal or [[postmenopausal]].
|-
|Yolk sac tumor
|They are most common in women in the second and third decades of life and rarely happens after the age 40.<ref name="pmid63318">{{cite journal |vauthors=Kurman RJ, Norris HJ |title=Endodermal sinus tumor of the ovary: a clinical and pathologic analysis of 71 cases |journal=Cancer |volume=38 |issue=6 |pages=2404–19 |date=December 1976 |pmid=63318 |doi= |url=}}</ref>
|-
|Embryonal carcinoma
|They affect primarily children and young adults.<ref name="AL HusainiSoudy2012" />
|-
|Choriocarcinoma
|
*They can be primary (non-[[Gestation period|gestational]]) or secondary to [[pregnancy]] ([[Gestational age|gestational]]).<ref name="AL HusainiSoudy2012" />
*Primary type affects children and young adults.
|}


===Race===
===Race===
*There is no racial predilection to [disease name].
*[[Ovarian]] [[germ cell]] [[tumors]] has been observed to have higher [[incidence]] among non-white [[Ethnicity and health|ethnicity]] (other than black, especially Hispanic and Asians) followed by white and black individuals.<ref name="pmid16648414">{{cite journal |vauthors=Smith HO, Berwick M, Verschraegen CF, Wiggins C, Lansing L, Muller CY, Qualls CR |title=Incidence and survival rates for female malignant germ cell tumors |journal=Obstet Gynecol |volume=107 |issue=5 |pages=1075–85 |date=May 2006 |pmid=16648414 |doi=10.1097/01.AOG.0000216004.22588.ce |url=}}</ref>
*[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
*[[Dysgerminoma]] has been reported to have two times higher [[incidence]] rate among white and other non-whites than among blacks.
 
===Gender===
===Gender===
*[Disease name] affects men and women equally.
*Females are more commonly affected by [[germ cell]] [[tumors]] than males.<ref name="SmithBerwick2006">{{cite journal|last1=Smith|first1=Harriet O.|last2=Berwick|first2=Marianne|last3=Verschraegen|first3=Claire F.|last4=Wiggins|first4=Charles|last5=Lansing|first5=Letitia|last6=Muller|first6=Carolyn Y.|last7=Qualls|first7=Clifford R.|title=Incidence and Survival Rates for Female Malignant Germ Cell Tumors|journal=Obstetrics & Gynecology|volume=107|issue=5|year=2006|pages=1075–1085|issn=0029-7844|doi=10.1097/01.AOG.0000216004.22588.ce}}</ref>
*[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
 
===Region===
===Region===
*The majority of [disease name] cases are reported in [geographical region].
*[[Germ cell]] [[tumors]] of the [[ovary]] account for a greater proportion of [[ovarian]] [[tumors]] in the Asia and Africa.<ref name="SmithBerwick2006">{{cite journal|last1=Smith|first1=Harriet O.|last2=Berwick|first2=Marianne|last3=Verschraegen|first3=Claire F.|last4=Wiggins|first4=Charles|last5=Lansing|first5=Letitia|last6=Muller|first6=Carolyn Y.|last7=Qualls|first7=Clifford R.|title=Incidence and Survival Rates for Female Malignant Germ Cell Tumors|journal=Obstetrics & Gynecology|volume=107|issue=5|year=2006|pages=1075–1085|issn=0029-7844|doi=10.1097/01.AOG.0000216004.22588.ce}}</ref>
 
*[[Dysgerminoma|Dysgerminomas]] has been reported to have high [[prevalence]] in India and Japan.<ref name="AL HusainiSoudy2012">{{cite journal|last1=AL Husaini|first1=Hamed|last2=Soudy|first2=Hussein|last3=Darwish|first3=Alaa El Din|last4=Ahmed|first4=Mohamed|last5=Eltigani|first5=Amin|last6=AL Mubarak|first6=Mustafa|last7=Sabaa|first7=Amal Abu|last8=Edesa|first8=Wael|last9=AL-Tweigeri|first9=Taher|last10=Al-Badawi|first10=Ismail A.|title=Pure dysgerminoma of the ovary: a single institutional experience of 65 patients|journal=Medical Oncology|volume=29|issue=4|year=2012|pages=2944–2948|issn=1357-0560|doi=10.1007/s12032-012-0194-z}}</ref>
*[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
 
===Developed Countries===
 
===Developing Countries===


==References==
==References==

Latest revision as of 13:48, 22 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Monalisa Dmello, M.B,B.S., M.D. [3]

Overview

In USA, the age-adjusted incidence of malignant ovarian germ cell tumor is 0.41 per 100,000 women. Incidence of these tumors increases from 5 years of age, although it may be present during infancy, and this increase continues to peak between the age of 15 to 19 years which is approximately 1.2 per 100,000 women. Another peak incidence of these tumors has been reported among those aged 65 years old or older where teratoma is the most common type observed. The incidence is higher among non-white ethnicity (other than black, especially Hispanic and Asians) followed by white and black individuals. Females are more commonly affected by germ cell tumors than males. These tumors also account for a greater proportion of ovarian tumors in the Asia and Africa.

Epidemiology

Incidence

Incidence of Ovarian germ cell tumors
Mature teratoma
Dysgerminoma
Yolk sac tumor Age-adjusted incidence of this tumor is 0.048 per 100,000 women-year.[6]
Embryonal carcinoma Age-adjusted incidence of this tumor is 0.014 per 100,000 women-year.[6]
Choriocarcinom Age-adjusted incidence of this tumor is 0.008 per 100,000 women-year.[6]

Prevalence

Prevalence of Ovarian germ cell tumors
Mature teratoma Mature teratoma is the most common ovarian germ cell tumor and accounts for 95% of ovarian teratomas.[8]
Dysgerminoma
Mixed germ cell tumor
Embryonal carcinoma These tumors are very rare, comprising only 1% of ovarian germ cell tumors, and usually are a component of mixed germ cell tumors.[11]
Endodermal sinus tumor The pure form of these tumors are the third most common ovarian tumors.[10]
Non-gestational choriocarcinoma These tumors comprised less than 1% of malignant ovarian germ cell tumors.[12]

Demographics

Age

Age
Mature teratoma Patients of all age groups may develop mature teratoma. However, they tend to present between 20 to 30 years of age at a greater extent.[14]
Immature teratoma Immature teratoma tends to affect younger patient than mature teratomas (usually the first 2 decades of life).[15]
Dysgerminoma
  • Dysgerminoma commonly affects individuals younger than 30 years of age in 85% of cases.[9]
  • The median age at the time of diagnosis is approximately 19 to 23 years, although it may happen at any age.[16]
  • The tumor is uncommon prepubertal or postmenopausal.
Yolk sac tumor They are most common in women in the second and third decades of life and rarely happens after the age 40.[17]
Embryonal carcinoma They affect primarily children and young adults.[16]
Choriocarcinoma

Race

Gender

Region

References

  1. 1.0 1.1 Quirk, Jeffrey T.; Natarajan, Nachimuthu; Mettlin, Curtis J. (2005). "Age-specific ovarian cancer incidence rate patterns in the United States". Gynecologic Oncology. 99 (1): 248–250. doi:10.1016/j.ygyno.2005.06.052. ISSN 0090-8258.
  2. 2.0 2.1 Møller H, Evans H (January 2003). "Epidemiology of gonadal germ cell cancer in males and females". APMIS. 111 (1): 43–6, discussion 46–8. PMID 12752232.
  3. 3.0 3.1 3.2 dos Santos Silva I, Swerdlow AJ (May 1991). "Ovarian germ cell malignancies in England: epidemiological parallels with testicular cancer". Br. J. Cancer. 63 (5): 814–8. PMC 1972374. PMID 1645564.
  4. 4.0 4.1 Pectasides, D.; Pectasides, E.; Kassanos, D. (2008). "Germ cell tumors of the ovary". Cancer Treatment Reviews. 34 (5): 427–441. doi:10.1016/j.ctrv.2008.02.002. ISSN 0305-7372.
  5. Westhoff C, Pike M, Vessey M (July 1988). "Benign ovarian teratomas: a population-based case-control study". Br. J. Cancer. 58 (1): 93–8. PMC 2246492. PMID 3166898.
  6. 6.0 6.1 6.2 6.3 6.4 6.5 Smith, Harriet O.; Berwick, Marianne; Verschraegen, Claire F.; Wiggins, Charles; Lansing, Letitia; Muller, Carolyn Y.; Qualls, Clifford R. (2006). "Incidence and Survival Rates for Female Malignant Germ Cell Tumors". Obstetrics & Gynecology. 107 (5): 1075–1085. doi:10.1097/01.AOG.0000216004.22588.ce. ISSN 0029-7844.
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