eMedicine Specialties > Pediatrics: General Medicine > Oncology

Gonadoblastoma: Follow-up

Author: Joseph L Lasky III, MD, Clinical Assistant Professor, Department of Pediatrics, Division of Hematology and Oncology, Mattel Children's Hospital UCLA
Coauthor(s): Kathleen M Sakamoto, MD, PhD, Professor and Chief, Division of Hematology-Oncology, Vice-Chair of Research, Mattel Children's Hospital at UCLA; Department of Pathology and Laboratory Medicine, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA and California Nanosystems Institute and Molecular Biology, UCLA; Dimitri Kuznetsov, MD, Staff Physician, Department of Surgery, Section of Urology, University of Chicago; Nejd F Alsikafi, MD, Clinical Associate, Department of Urology, Mount Sinai Hospital; William J Cromie, MD, MBA, President and Chief Executive Officer, Health Care, Capital District Physicians' Health Plan
Contributor Information and Disclosures

Updated: Nov 26, 2008

Follow-up

Further Outpatient Care

  • After gonadectomy, discharge patients who had gonadoblastoma home with pain medication.
  • Schedule a return visit in the clinic within 2 weeks to make sure the incision has healed well.

Complications

  • Treatment for an individual with gonadoblastoma is surgical, and the main complications observed are related to the wound (eg, infection).

Prognosis

  • The prognosis of patients with gonadoblastoma is excellent if the tumor is removed before the transformation to a malignant germinoma/seminoma occurs.
  • With platinum-based chemotherapy, success rates of curing dysgerminoma/seminoma can be greater than 90%.
  • Identify and treat patients at risk of developing these lesions early in life to reduce the possibility of sustaining morbidity and mortality from these lesions.
  • Successful pregnancy has been achieved in patients with gonadal dysgenesis (45,XO; 46,XY; and others) following stimulation of uterine growth with cyclical hormone replacement. Patients with a Y chromosome should have prophylactic gonadectomies, if they have not had one previously. These can often be at the same time as delivery, which usually requires a Cesarean delivery.

Miscellaneous

Medicolegal Pitfalls

  • The exclusive occurrence of this unique malignancy in patients with intersex disorders has been well established. Although some forms of intersexuality can be difficult to diagnose, most patients at risk of developing gonadoblastoma can be treated appropriately in a timely fashion. In families and patients with Turner syndrome (45,X), gonadal dysgenesis (45,X/46,XY), or androgen insensitivity/male pseudohermaphrodism (46,XY), provide counseling regarding the risk of developing gonadoblastoma and clearly state the appropriate treatment. Failure to inform and treat these individuals in a timely fashion can lead to unnecessary morbidity and can place the institution and staff at liability.
 


More on Gonadoblastoma

Overview: Gonadoblastoma
Differential Diagnoses & Workup: Gonadoblastoma
Treatment & Medication: Gonadoblastoma
Follow-up: Gonadoblastoma
References
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References

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Further Reading

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Keywords

gonadoblastoma, intersex disorders, germinoma, seminoma, gonadal dysgenesis, complete androgen insensitivity, male pseudohermaphrodites, male pseudohermaphroditism, male pseudohermaphrodism, mixed gonadal dysgenesis, Turner syndrome, Turner's syndrome, germ cell tumors, testicular seminoma, amenorrhea, clitoromegaly, abnormal hirsutism, inguinal hernias, hypoplastic vagina

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Contributor Information and Disclosures

Author

Joseph L Lasky III, MD, Clinical Assistant Professor, Department of Pediatrics, Division of Hematology and Oncology, Mattel Children's Hospital UCLA
Joseph L Lasky III, MD is a member of the following medical societies: American Association for Cancer Research, American Society of Clinical Oncology, American Society of Pediatric Hematology/Oncology, Children's Oncology Group, and Society for Neuro-Oncology
Disclosure: Nothing to disclose.

Coauthor(s)

Kathleen M Sakamoto, MD, PhD, Professor and Chief, Division of Hematology-Oncology, Vice-Chair of Research, Mattel Children's Hospital at UCLA; Department of Pathology and Laboratory Medicine, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA and California Nanosystems Institute and Molecular Biology, UCLA
Kathleen M Sakamoto, MD, PhD is a member of the following medical societies: American Society of Hematology, American Society of Pediatric Hematology/Oncology, New York Academy of Sciences, Society for Pediatric Research, and Western Society for Pediatric Research
Disclosure: Nothing to disclose.

Dimitri Kuznetsov, MD, Staff Physician, Department of Surgery, Section of Urology, University of Chicago
Dimitri Kuznetsov, MD is a member of the following medical societies: American Urological Association and Endourological Society
Disclosure: Nothing to disclose.

Nejd F Alsikafi, MD, Clinical Associate, Department of Urology, Mount Sinai Hospital
Nejd F Alsikafi, MD is a member of the following medical societies: American Urological Association and Endourological Society
Disclosure: Nothing to disclose.

William J Cromie, MD, MBA, President and Chief Executive Officer, Health Care, Capital District Physicians' Health Plan
William J Cromie, MD, MBA is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Medical Association, American Urological Association, Medical Society of the State of New York, Société Internationale d'Urologie (International Society of Urology), Society for Pediatric Urology, Society of University Urologists, and Society of Uroradiology
Disclosure: Nothing to disclose.

Medical Editor

Stephan A Grupp, MD, PhD, Director, Stem Cell Biology Program, Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia; Associate Professor of Pediatrics, University of Pennsylvania
Stephan A Grupp, MD, PhD is a member of the following medical societies: American Association for Cancer Research, American Society for Blood and Marrow Transplantation, American Society of Hematology, American Society of Pediatric Hematology/Oncology, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Timothy P Cripe, MD, PhD, Professor of Pediatric Hematology/Oncology, University of Cincinnati; Director, Translational Research Trials Office, Department of Pediatrics, Cincinnati Children's Hospital Medical Center
Timothy P Cripe, MD, PhD is a member of the following medical societies: American Association for the Advancement of Science, American Pediatric Society, American Society of Hematology, American Society of Pediatric Hematology/Oncology, and Society for Pediatric Research
Disclosure: Nothing to disclose.

CME Editor

Helen SL Chan, MBBS, FRCP(C), FAAP, Senior Scientist, Research Institute; Professor, Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Canada
Helen SL Chan, MBBS, FRCP(C), FAAP is a member of the following medical societies: American Academy of Pediatrics, American Association for Cancer Research, American Society of Hematology, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Chief Editor

Max J Coppes, MD, PhD, MBA, Executive Director, Center for Cancer and Blood Disorders, Children's National Medical Center; Professor of Medicine, Oncology, and Pediatrics, Georgetown University
Max J Coppes, MD, PhD, MBA is a member of the following medical societies: American Association for Cancer Research, American Society of Pediatric Hematology/Oncology, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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