Exceedingly Rare Adolescent Ovarian Dysgerminoma Choriocarcinoma Masquerading as Ectopic Pregnancy: Insights into a Rare Clinical Entity and a Clinicopathological Conundrum

Mixed ovarian germ cell tumors containing a choriocarcinoma component are rare and aggressive malignancies, predominantly affecting children and adolescents. These tumors often present with markedly elevated serum β-human chorionic gonadotropin (β-hCG) and may clinically mimic ectopic pregnancy or gestational trophoblastic disease, leading to diagnostic delays. We report the case of a 15-year-old female who presented with a right tubo-ovarian mass and significantly elevated β-hCG levels. Histopathological examination and immunohistochemistry confirmed a mixed germ cell tumor composed of dysgerminoma and choriocarcinoma. This case highlights the diagnostic challenges, the critical role of immunohistochemistry in tumor classification, and the importance of early recognition of nongestational trophoblastic differentiation in ovarian tumors.