Alpha-fetoprotein and human chorionic gonadotropin in embryonal carcinoma of the ovary. An 8-year survival case.

An 11-year-old female with a large embryonal carcinoma of the left ovary was treated by unilateral salpingo-oophorectomy combined with a systemic chemotherapy of a total dose of 1.9 mg of dactinomycin. The preoperative serum alpha-fetoprotein (AFP) level of 70,350 ng/ml decreased to 270 ng/ml 5 weeks after the operation. Thereafter, the serum AFP level remained within a normal range. The preoperative urinary human chorionic gonadotropin (HCG) level of 16,000 IU/L fell to a normal range 3 days after the surgery. Histologic sections of the tumor showed embryonal carcinoma. HCG was identified in the syncitiotrophoblastic giant cells and AFP was identified within the mononuclear epithelial cells and in some hyaline droplets in the tumor by using the immunohistochemical technique. The patient has survived 8 years after the operation. It was concluded that the patient had a very rare ovarian embryonal carcinoma, in which AFP and HCG were identified immunohistochemically.