Clinicopathologic Study on the Primary Malignant Tumors of The Fallopian Tube / 대한산부인과학회잡지

Objective The aim of this study was to evaluate the clinicopathologic findings of eight patients with primary cancer of fallopian tube diagnosed and treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center for nine years. Methods Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and survival of patients were reviewed retrospectively. Results The patients with primary cancer of fallopian tube constituted 0.4% of all gynecologic malignancies encountered during this period. The age of patients ranged 42 to 70 years(mean+/- S.D.; 53.9+/-9.9) and half of patients were postmenopausal and two patients were nulliparous. Patients were treated by simple or radical hysterectomy and bilateral salpingoophorectomy with or without omentectomy and five patients received postoperative chemotherapy. The FIGO surgical stages of the patients were I(4 cases), II(2 cases), III(1 case) and IV(1 case). There were 3 cases of adenocarcinoma, 3 cases of malignant mixed Mullerian tumor, 1 case of undifferentiated carcinoma and 1 case of serous cystic tumor of low malignancy potential. Serum CA 125 values were followed during treatment and decreased during clinical remission and increased at the time of tumor progression. The mean follow-up duration was 24.3(+28.3) months and 7 patients were alive free of disease and one patients with stage Ic died of the disease. Conclusion Primary fallopian tube cancer is an extremely rare malignancy of the female genitalia and preoperative diagnosis of this disease is difficult. Cytoreductive surgery and postoperative combination chemotherapy seem to be effective treatment and CA 125 value could reflect the disease status during the treatment and follow-up of patients.

Immunohistochemical Study on the Nitric Oxide Synthase Neurons in the Brain Stem of Rats / 대한해부학회지

Nitric oxide (NO), a free radical that has been postulated to act as a neurotransmitter, neuromodulator, or second messenger molecule in nervous system, is synthesized from L-arginine by nitric oxide synthase (NOS). The NADPH-diaphorase (NADPH-d) histochemical techenique provides a simple and robust method to stain the selected populations of NOS neurons in the brain. This study was aimed to clarify the distribution of NOS neurons in the brain stem of rats. To verify the distribution of NOS neurons in the brain stem, the neurons were stained by the NOS immunohis-tochemistry and NADPH-d histochemistry. Image analyzer-assisted densitometry and cell counting method have been used to quantitatively characterize groups of neuronal cells. Double labeling of NOS immunohistochemistry and NADPH-d histochemistry showed the coexistence of NOS and NADPH-d in same neurons. Neuronal cell bodies exhibiting NOS/NADPH-d staining were found in particular nuclei throughout the brain stem. The number of NOS/NADPH-d neurons were variable in brain stem nuclei. The NADPH-d neurons exhibited different intensities of reaction product. Some groups, including paradorsal raphe nucleus, laterodorsal tegmental nucleus and pedunculopontine tegmental nucleus were extremely heavily stained. Other neurons such as those in the interpeduncular nucleus, central gray, substantia nigra lateralis, nucleus solitarius and raphe obscurus nucleus were moderately stained, while other neurons such supragenual nucleus, lateral paragigantocellular nucleus and prepositus hypoglossal nucleus were weakly stained. The present study describes the many locations within the brain stem in which NADPH-d occurs. Since NADPH-d activity colocalizes with NOS, the results indicate the likely involvement of nitric oxide in the neuronal functions of many brain stem nuclei of rats.

The Significance of High-Hisk HPV Infection and Resection Margin Status in CIN Treated by LEEP / 대한부인종양콜포스코피학회잡지

This study evaluated the degree and the frequency of cervical lesions after treatment with LEEP(loop electrosurgical excision procedure) in patients with abnormal Pap smears according to the presence or absence of high-risk HPV infection. From June 1994 to May 1997, eighty patients who showed CIN or chronic cervicitis on LEEP specimens were followed up with Pap smears. The histologic results and follow-up Pap smear data were analyzed. In all cases HPV test by Hybrid Capture assay was performed. Those with neoplastic lesion underwent follow-up Pap smears at least for 1 year with 3 month interval after LEEP. In HPV-positive group(N 38), 63.2% of the cases revealed neoplastic lesion(CIN) on final histologic evaluation, and in HPV-negative group(N 42) 54.8% of the cases did(p 0.26). HPV-positive group represented 25.0%(6/24) of abnormal Pap smear result on follow-up, which is higher than that of HPV-negative group(4.3%; 1/23), showing significant difference (p<0.05). There was a significant difference in the rate of neoplastic lesion developed during follow-up between resection margin-positive group and resection margin-negative group on LEEP(p 0,04). Also, HPV-positive group had significantly higher chance to show abnormal Pap smear results during follow-up(p 0.02). In conclusion, HPV test and margin status were shown to be useful parameters to predict the recurrence or persistence of CIN lesion treated by LEEP.

Presence of Mycoplasma DNA in Ovarian Cancer Tissue: Detection by PCR-ELISA Technique / 대한부인종양콜포스코피학회잡지

Mycoplasmas, cell wall-less bacteria of class Mollicutes, are among the smallest self-replicating organisms known and reside ubiquitously at the cell membrane or internalized into the cell. They mimic viruses in many of their activities and further they may have oncogenic activity. The oncogenic potential of mycoplasmas was only recently realized when they were shown to cause chromosomal changes and in vitro cell transformations through gradual progressive chromosomal loss and translocations. The association between these organisms and human cancers has been evaluated and actually mycoplasmas were detected in 50% of gastric cancers. In gynecologic cancer, one study demonstrated a 59.3% prevalence rate of mycoplasmas in malignant ovarian tumors but the explanations for the association between the organisms and ovarian cancer might be somewhat confusing, at least in part, due to absence of normal control. The present objective was to determine the presence of mycoplasma DNA in ovarian cancer tissues and normal ovary in Korea. Fresh frozen tissue samples stored at -72 degrees C were used for mycoplasma DNA assay. The study materials comprised twenty-nine human ovarian cancer tissues and ten normal ovarian tissues. After extraction of DNA, the combined PCR-ELISA(polymerase chain reaction and enzyme linked immunosorbent assay) procedure was performed with consensus primers targeting for 15 species of mycoplasmas and acholeplasmas together with negative and positive controls, which was known as very sensitive method. The results showed mycoplasma DNA were present in none of normal ovarian tissue and in 13.8%(4 of 29) of the ovarian cancer specimens, which is much lower than that of the previousstudy. Three positive cases showed very strong reactivities, but there was no significant correlation between presence of mycoplasma DNA and the clinicopathological characteristics of the patients. These results suggest that mycoplasma can not be the contributor in the mechanism of carcinogenesis in the most of ovarian cancers in Korea, but the association between mycoplasma and ovarian cancer is worth to be investigated.

Effect of Tumor Grade and FIGO Stage on Preoperative Serum CA 125 Level in Epithelial Ovarian Cancer / 대한부인종양콜포스코피학회잡지

The preoperative serum level of tumor marker CA 125 has served as rough orientation in making the distinction between a benign and a malignant adnexal mass or as a reference for monitoring the success of therapy. But there were some reports suggesting that the stage of the disease and tumor grade, which are known to be the independent prognostic factors in ovarian cancer patients, may exert an influence on the preoperative CA 125 level. In this retrospective study we analysed the significance of preoperative serum CA 125 level with respect to tumor grade and tumor stage. Between June, 1989 and January, 1997, 82 patients with epithelial ovarian cancer managed at Asan Medical Center were evaluated, in whom serum level CA 125 were measured preoperatively. Tumor grade bears no meaningful influence on the preoperative CA 125 level, and also the correlation is low and statistically insignificant (r=0.12, p=0.29 in all stages; r=0.01, p=0.97 in stage I; r=-0.09, p=0.83 in stage II; r=0.06, p=0.72 in stage III; r=0.25, p=0.41 in stage IV). There was no significant effect of FIGO stage on preoperative CA 125 level (r=0.21, p=0.06 in all grades; r=0.32, p=0.10 in G1; r=0.08, p=0.74 in G2; r=0.17, p=0.30 in G3). However, we found a significant correlation between FIGO stage and tumor grade (r=0.45, p<0.01). In conclusion, our data suggests that both tumor grade and FIGO stage have no significant effect on preoperative serum CA 125 level.

Clinical and Pathologic Characteristics of Uterine Sarcoma / 대한부인종양콜포스코피학회잡지

Uterine sarcomas are rare, characterized by rapid clinical progression and poor prognosis, and their management has been a challenge. The purpose of this study was to investigate the clinical and pathologic characteristics of patients with uterine sarcoma managed in the department of Obstetric and Gynecology, college of medicine, University of Ulsan, Asan Medical center, Seoul, Korea from June 1989 to August 1998. Data including clinical and histologic findings, treatment and outcome of nineteen patients were evaluated. The age of patients ranged 22 to 71 years (mean+/-S.D.; 46.9+/-13.1) and half of patients were postmenopausal and four patients were nulliparous. Palpable pelvic mass or abnormal uterine bleeding were the most common sign or symptom. Twelve patients (63.2%) had stage I disease and seven (36.8%) had stage III disease. There were 13 cases (68.4%) of leiomyosarcoma, 4 cases (21.1%) of endometrial stromal sarcoma, 2 cases (10.5%) malignant mixed mullerian tumor. All except one received hysterectomy (simple or radical) with or without bilateral salpingo-oophorectomy. Some received omentectomy or pelvic lymphadenectomy. Postoperative chemotherapy was administered in ten patients with regimen of VAC, VBP, VIC and etc. The mean follow-up duration was 29.3 (+/- 24.7) months and 5 patients died of the disease resulting 2-year survival of 68.1%. FIGO stage and mitotic count were considered to have prognostic significance, but without statistical confirmation. In conclusion, uterine sarcomas are aggressive tumors with a poor prognosis. Our data showed excellent outcome in early disease with surgery with or without adjuvant chemotherapy, whereas there was no long-term survivor in advanced disease despite postoperative chemotherapy.

Malignant Germ Cell Tumors of the Ovary: A Clinical and Pathological Study of 42 Cases / 대한부인종양콜포스코피학회잡지

From July, 1989 to June, 1998 forty-two patients with malignant germ cell tumors of the ovary treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center, were identified. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow-up of those patients were reviewed retrospectively. The patients with malignant germ cell tumor constituted 11.1% of all ovarian malignancies and 5.6% of all ovarian germ cell tumors ecountered during this period. The most common histologic subtype was dysgerminoma (26.2%) followed by endodermal sinus tumor (23.8%) and immature teratoma (19.0%). The age of the patients ranged from 8 to 64 years (mean+/-S.D.; 26.0+/-12.9) and the mean parity was 0.8 (+/-1.6). The most frequent initial symptoms were adbominal pain (33.3%) or abdominal distension (31.0%). Most had stage I(25 cases, 59.9%) or II(6 cases, 14.3%) diseases. Elevated level of serum alpha-FP was observed in all cases of endodermal sinus tumor and embryonal cell carcinoma, CA 125 was elevated in 63.9% of all malignant germ cell tumors. Thirty-one patients (73.8%) were treated by surgery and chemotherapy and 10 patients (23.8%) by surgery only. The major chemotherapeutic regimens were BEP (bleomycin +etoposide +cisplatin) and VAC (vincristine +actinomycin-D +cytoxan). The mean follow-up duration was 24.6 (+/-23.5) months and 2-year survival rate was 88.6% (+/-0.6).

Primary Clear Cell Carcinoma of the Ovary ; An Analysis of 9 Cases with Review of the Literature / 대한산부인과학회잡지

Clear cell carcinoma of the ovary is a clinicopathologic entity with distinct morphologic characteristics and known to be associated with poor prognosis irrespective of stage and prognostic benefits of chemotherapy have not been evidently demonstrated. This represents 2-3.6% of all ovarian malignancies. From October, 1991 to January, 1998, nine patients with primary clear cell carcinoma of the ovary treated in the deptartment of Gynecology and Obstetrics, University of Ulsan, Asan Medical Center were identified, and clinical and histologic review(including architectural pattern, mitotic activity, nuclear grading) was performed retrospectively. The age of the patients ranged from 30 to 67 year(mean+S.D.; 46.0+11.8) and the mean parity was 1.2 (+1.3). Five(55.6%) of nine patients had elevated level of CA 125. The size of the tumors varied from 3 cm to 20 cm with the mean maximal diameter of 12.1 (+6.3) cm. The FIGO stages of the patients were IC(6 cases, 66.7%), IIC (2 cases, 22.2%) and IV(1 case, 11.1%). All patients except one were treated by total abdominal hysterectomy and bilateral salpingoophorectomy with or without omentectomy and pelvic lymph node dissection. All except two were received postoperative chemotherapy with regimens such as CEC (cyclophosphamide + epirubicin + carboplatin), TC(taxol + carboplatin), CC(cyclophosphamide + carboplatin) or CAP (cyclophosphamide + adriamycin + cisplatin). The mean follow-up duration was 14.6 (+ 8.6) months and 8 patients were free of disease and one patient with stage IV disease died of disease during postoperative chemotherapy(4 months after surgery).

The Brenner Tumors of The Ovary: A Clinicopathologic Study / 대한부인종양콜포스코피학회잡지

The aim of this study was to evaluate the clinicopathologic findings of twelve patients with Brenner tumor of the ovary diagnosed and treated in the department of Gynecology and Obstetrics, University of Ulsan, Asan Medical Center for nine years. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow-up were reviewed retrospectively. The patients with Brenner tumor constituted 0.54% of all epithelial ovarian tumor ecountered during this period. The age of patents ranged from 47 to 79 years (mean+/-S.D.; 60.1+/-11.9) and the mean parity was 3.3. Eleven cases except one, who had FIGO stage Ia disease, had benign tumors. The tumor size ranged from 0.5 to 12 cm (mean+/-S.D.; 4.8+/-3.8 cm). Uterine adenomyosis was the most frequently associated disease (58.3%) and all tumors were unilateral. Total abdominal hysterectomy with unilateral or bilateral salpingoophorectomy were performed in all patients and no further postoperative adjuvant treatments were done even in the patient with malignant tumor, who is alive without evidence of disease.

The Brenner Tumors of The Ovary: A Clinicopathologic Study / 대한부인종양콜포스코피학회잡지

The aim of this study was to evaluate the clinicopathologic findings of twelve patients with Brenner tumor of the ovary diagnosed and treated in the department of Gynecology and Obstetrics, University of Ulsan, Asan Medical Center for nine years. Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and results of follow-up were reviewed retrospectively. The patients with Brenner tumor constituted 0.54% of all epithelial ovarian tumor ecountered during this period. The age of patents ranged from 47 to 79 years (mean+/-S.D.; 60.1+/-11.9) and the mean parity was 3.3. Eleven cases except one, who had FIGO stage Ia disease, had benign tumors. The tumor size ranged from 0.5 to 12 cm (mean+/-S.D.; 4.8+/-3.8 cm). Uterine adenomyosis was the most frequently associated disease (58.3%) and all tumors were unilateral. Total abdominal hysterectomy with unilateral or bilateral salpingoophorectomy were performed in all patients and no further postoperative adjuvant treatments were done even in the patient with malignant tumor, who is alive without evidence of disease.

Bcl-2 Expression in Endometrial Hyperplasia and Carcinoma / 대한암학회지

PURPOSE: To speculate the role of bcl-2 protooncogene in endometrial carcinogenesis by determination of the expression of bcl-2 in endometrial hyperplasia and carcinoma. MATERIALS AND METHODS: We studied bcl-2 expression by an immunohistochemical method in the paraffin-embedded blocks of 78 patients with endometrial hyperplasia, 64 with simple hyperpasia, 9 with complex hyperplasia and 5 with atypical hyperplasia respectively, and 33 endometrial carcinoma treated at Asan Medical Center from June, 1989 to May, 1997. Intensity of bcl-2 staining was scored on a scale of 0 to 4, calibrated by comparison with stromal lymphocytes, which always received a score of 4. RESULTS: The results of this study showed that bcl-2 was relatively highly expressed in simple (n= 64), complex (n=9) and atypical hyperplasias (n=5) with mean staining scores of 2.95+/-1.09 (Mean+Standard Deviation), 2.78+/-1.20 and 3.60+/-0.89 respectively, which showed no difference among histologic types. In endometrial carcinoma, the expression of bcl-2 was significantly down regulated (mean score=1.76+/-1.35) compared with that of hyperplasia, and did not conelate with FIGO surgical stage. However, grade III tumor showed significantly lower expression that grade I or II tumor. CONCLUSION: Bcl-2 expression is down regulated in endometrial carcinoma than endo- metrial hyperplasia, and correlates with tumor grade, which suggest that bcl-2 expression might be the result of carcinogenesis or bcl-2 plays only an adjunctive role in the endometrial carcinogenesis.

Significance of Thrombocytosis in Patients with Epithelial Ovarian Cancer / 대한부인종양콜포스코피학회잡지

Thrombocytosis(a platelet count>400,000/mm3) is found to be frequently in association with malignant disease and recently has been suggested to be a poor prognostic indicator in patients with certain cancers. The objective of this retrospective study was to determine the relevance of a preoperative platelet count in ovarian cancer with a possible prognostic significance of thrombocytosis in this disease. Between June 1989 and December 1995, eighty-five patients with epithelial ovarian cancer were evaluated, who were managed at Asan Medical Center by cytoreductive surgery and chemotherapy, and had at least 6 months' follow-up. Prevalence of thrombocytosis was 22.4% and significantly correlated with FIGO stage(p=0.003), histologic subtype(p=0.002), tumor grade(p=0.040), performance status of patient(p=0.006) and preoperative serum CA 125 level(p=0.002). And the linear regression analysis revealed a significant correlation(p<0.001) between platelet count and preoperative serum CA 125 level, which suggested that platelet count was positively associated with tumor volume. No difference in survival between patients with or without thrombocytosis was found(p=0.68), whereas residual tumor size and serum CA 125 level after 2nd chemotherapy were found to be independent prognostic factors. In conclusion, thrombocytosis is not a useful prognostic factor in epithelial ovarian cancer, but significantly associated with tumor volume.

Prediction of Size of Residual Discase after Initial Surgery by Postoperative Decline of Serum CA 125 Levels in Patients with Advanced Epithelial Ovarian Cancer / 대한산부인과학회잡지

In this retrospective study, we assessed the clinical usefulness of postoperative decline of serum CA 125 level after initial surgery to predict the size of residual disease in patients with advanced epithelial ovarian cancer. Between June 1989 and December 1995, sixty-three patients with advanced epithelial ovarian cancer (FIGO stage II-IV) were evaluated, who were managed at Asan Medical Center by cytoreductive surgery followed by chemotherapy. All patients had elevated preoperative serum CA 125(>35U/ml) and had another serum CA 125 assay 7~10 days after surgery. Preoperative CA 125 levels were similar in patients with residual disease below 2 cm and in those with larger residuum. The postoperative decline of serum CA 125 was significantly higher in patients with smaller residual disease only if preoperative serum CA 125 value was over 400U/ml. By taking 70% as the cutoff of CA 125 decline for discriminating patients with residual disease above 2 cm, the specificity and positive predictive value of this parameter improved when we considered patients with increasing preoperative serum levels. Hence, in the subset of patients with preoperative serum CA 125 level over 400U/ml, 95.2% (20/21) of patients with residual disease below 2 cm showed postoperative decline of serum CA 125 level over 70%, and 91.7%(11/12) of patients with postoperative decline of serum CA 125 level below 70% had residual disease over 2 cm. In conclusion, postoperative decline of serum CA 125 level after initial surgery does not exactly reflect the size of residual disease, but shows limited clinical usefulness in subset of patients with preoperative serum CA 125 level over 400 U/ml.

The Effectiveness of Power Doppler Ultrasonography in Assessment of Ovarian Tumor-Preliminary Study / 대한산부인과학회잡지

Recently, a method of color Doppler sonography has been described that is based onestimation the integrated Doppler power spectrum which is represented as "Power Doppler"ultrasonography. Several potential advantages of Power Doppler ultasonography overconventional color Doppler ultrasonography include that noise is represented in uniform patternin power mode, the relative angle independence and abscence of aliasing effect. It appearsto be a potentially useful particularly for evaluating slow flow in parts of the body wherethe signal is weak because blood vessels are small or deep. This could be applied to theevaluation of the flow in the ovarian tumors. And it is believed that the analysis of bloodflow characteristics as well as angiogenesis location and the amount and arrangement ofmicrovascular network may help in distinguishing malignant versus benign tumors.We will represent a preliminary report to demonstrate a efficacy of power Dopplerultrasonography in the detection of ovarian tumor vascularity. Thirty-one patients with ovarianmasses were prospectively evaluated with power and conventional color Dopplersonography using 7.0 MHz endovaginal probe or 3.0 MHz transabdominal probe with a pulserepetition frequency of 700 Hz. The evaluation criteria were the detection of vasculature,the arterial waveform analysis if possible, and defining the vascular location. With conventionalcolor Doppler sonography, the vascularity within the ovarian tumors could be detectedin 74.2% of total patients, and 90.3% of total patients with power Doppler sonography,Doppler waveform analysis was possible in 83.9% of total patients with power Dopplersonography and in 71.0% at conventional color Doppler sonography. The vascular patternswithin each parts(solid area, septum, pericystic) of the ovarian tumors were relatively welldefined with power Doppler sonography as compare to those with conventional color Dopplersonography.In conclusion, power Doppler ultrasonography was shown to be superior to conventionalcolor Doppler ultrasonography in the depiction of ovarian intratumoral vasculature.

Quantitative Pathologic Variables as Prognostic Factors in Epithelial Ovarian Cancer / 대한부인종양콜포스코피학회잡지

No abstract available.

Immunohistochemical Study for Expression of p53, bcl-2 and Bax in Uterine Sarcoma / 대한부인종양콜포스코피학회잡지

Uterine sarcomas are rare tumors with unpredictable prognosis, comprising about 3% of uterine cancers. Little is known of epidemiologic risk factors and similarly, little work has been performed assessing molecular alterations in sarcomas. Proteins encoded by p53, bcl-2 and bax genes are important regulators of programed cell death, hence apoptosis. Alterations in the expression of these apoptosis-related genes can contribute to the development of most of human cancers, as well as possibly influence the prognosis of the cancer patients. Using antibodies specific for the p53, bcl-2 and bax proteins in combination with immunohistochemical methods, we examined for the first time the expression of these genes in 19 cases of uterine sarcoma, managed at Asan Medical Center between June, 1989 and December, 1996, including 13 leiomyosarcomas, 4 endodermal stromal sarcomas and 2 malignant mixed mullerian tumors. Twelve patients had stage I disease and 7 stage III, and 9 patients had tumors with mitoses less than 10 per 10 HPF, and the others had those with mitoses equal to or more than 10 per 10 HPF. The results were evaluated by semiquantitative analysis as non-(0%), low(1~25%), moderate(26~75%) and high expressors(>76%), and the latter two were defined as tumors with overexpression. The immunoreactivity of bcl-2 and bax appeared in the cytoplasm, while that of p53 was localized solely in the nuclei. p53 immunostaining revealed 4 non-expressors, 7 low, 3 moderate and 5 high expressors, showing 42.1% rate of overexpression. Immunostaining of bcl-2 showed 13 non-expressors, 2 low, 1 moderate and 3 high expressors, resulting 21.1% rate of overexpression and that of bax showed 1 non-expressors, 4 low, 6 moderate and 8 high expressors, resulting 73.7% rate of overexpression. We could not find any significant correlation among the degrees of the expressions of these three proteins. The overexpression of these three proteins did not show any significant association with stage of disease or mitotic count of tumor. In conclusion, although apoptosis-related factors such as p53, bcl-2 and bax are strongly suggested to play a certain role in tumorigenesis of uterine sarcoma, the correlation among them and prognostic implications need further investigation.

A Clinical Study of Malignant Germ Cell Tumors of the Ovary / 대한부인종양콜포스코피학회잡지

Malignant germ cell tumore occur in children and young women in reproductive age, of all the germ cell maligaanci orily pure dysgerminiomas had a high cure rate prior to 1970. This was due to the exquisite wdioseneitivity of these tumors. Multiple agent chemotherapy has dramatieally improved the pr nosis af patients with malignant ovarian germ cell tumors. The purpose of this study is to report the experience at Aaan Medical Center, department of Obstetrics and Gynecology, in 16 patients withmalignant ovarian germ cell tumors treated between July, l989 and June, l994. We analyzed the effect of age, histolagic subtype, FIGO stage, surgical pmcedurse and regimens of chemotherapy, on the prognosis of thwe tumors. The results obtained were as follows: 1. In histologic subtypes, dysgenninoma(38.0%), endodermal sinus tumor(25.0%), squamous cell carcinoma arising in mature cystic teratoma(19.0%), mixed cell tumor(6.0%), immature teratoma(6.0%), malignant ectodermal tumor in mature cystic teratoma(6.0%), were counted in order. 2. No site predilection was identifed. 3. Main initial symptoms were abdominal distension(31.0%), abdominal pain(31.0%), abdominal mass palpation(25.0%), amenorrhea(6.0%) in order. 4. Multiple tumor markers were considered to be useful in diagnosis and follow up of malignant germ cell tumors of ovary. 5. The mean age of malignant ovarian germ cell tumors was 29.5 years, and 11 cases(69.3%) of tumors under the age of 30.0 years. 6. The survival rate seemed to be decreased with advancing FIGO stage.