{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:11:52Z","timestamp":1778825512155,"version":"3.51.4"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>\n                    Ovarian dysgerminoma, a malignant germ cell tumor, rarely presents with endocrine manifestations. This report describes a rare case of an 8-year-old girl with virilization symptoms and markedly elevated serum testosterone, initially suggestive of a steroid-producing sex cord-stromal tumor. Histopathological examination revealed a dysgerminoma with highly unusual architectural patterns, including pseudoglandular, follicular, and tubular structures, along with prominent luteinized stromal cells. Immunohistochemistry was diagnostic, showing germ cell markers (SALL4+, OCT3\/4+, CD117+) and \u03b2-HCG-positive syncytiotrophoblasts associated with inhibin-\u03b1-positive stroma, thus explaining the androgen excess. Molecular profiling revealed concurrent\n                    <jats:italic>KRAS<\/jats:italic>\n                    and\n                    <jats:italic>CDK4<\/jats:italic>\n                    amplifications, providing a plausible mechanistic basis for the tumor\u2019s high proliferative index and aggressive behavior, and underscoring the biological heterogeneity underlying this rare presentation. The patient achieved sustained remission after surgery and chemotherapy during a follow-up period of five years and six months. This case underscores the significant diagnostic challenge posed by dysgerminomas mimicking sex cord-stromal tumors and highlights the critical role of an integrated diagnostic approach combining morphology, immunohistochemistry, and molecular profiling to avoid misdiagnosis and guide management.\n                  <\/jats:p>","DOI":"10.3389\/fonc.2026.1802097","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:43:02Z","timestamp":1778823782000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Ovarian dysgerminoma mimicking a sex cord-stromal tumor with hyperandrogenism: diagnostic challenges and molecular insights"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Pathology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajun","family":"Li","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifan","family":"Gao","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences, Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenxin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinfeng","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.31729\/jnma.7894","article-title":"Pediatric ovarian dysgerminoma: a case report","volume":"60","author":"Adhikari","year":"2022","journal-title":"Jnma J Nepal Med Assoc"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3109\/00016340903443684","article-title":"Malignant ovarian germ cell tumors: clinico-pathological presentation and survival outcomes","volume":"89","author":"Tangjitgamol","year":"2010","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.path.2019.01.005","article-title":"Germ cell tumors of the female genital tract","volume":"12","author":"Euscher","year":"2019","journal-title":"Surg Pathol Clin"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5545645","article-title":"Dysgerminoma with estrogen-producing functioning stroma presenting precocious puberty","volume":"2021","author":"Nagase","year":"2021","journal-title":"Case Rep Pathol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1158\/1538-7445.pedcan-pr04","article-title":"Novel somatic and germline mutations in intracranial germ cell tumors","volume":"511","author":"Wang","year":"2014","journal-title":"Nature"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1097\/pas.0000000000001687","article-title":"Dysgerminoma of the ovary: an analysis of 140 cases emphasizing unusual microscopic findings and resultant diagnostic problems","volume":"45","author":"Warnnissorn","year":"2021","journal-title":"Am J Surg Pathol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19900501)65:9<2001::aid-cncr2820650920>3.0.co;2-7","article-title":"Ovarian tumors with functioning stroma. 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Meigs syndrome with high levels of CA 125","volume":"20","author":"Stabile","year":"2021","journal-title":"Prz Menopauzalny"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1159\/000329477","article-title":"Gonadal development and tumor formation at the crossroads of male and female sex determination","volume":"5","author":"Cools","year":"2011","journal-title":"Sex Dev"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1802097\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:43:17Z","timestamp":1778823797000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1802097\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,15]]},"references-count":14,"alternative-id":["10.3389\/fonc.2026.1802097"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1802097","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,15]]},"article-number":"1802097"}}