Prognosis of Eight Chinese Cases of Primary Vaginal Yolk Sac Tumor with a Review of the Literature

Tang, Qiong-Lan,Jiang, Xue-Feng,Yuan, Xiao-Ping,Liu, Yong,Zhang, Lin,Tang, Xiao-Feng,Zhou, Jia-Jia,Li, Hai-Gang,Fang, Jian-Pei,Xue, Lin Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.21

Background: Primary vaginal yolk sac tumor is a rare malignancy in the pediatric population, and a diagnostic challenge and appropriate initial treatment remains unsolved. The aim of this study was to investigate the clinicopathologic features, treatment and prognosis of this tumor. Materials and Methods: Eight cases of primary vaginal yolk sac tumor were reported with a literature review. Results: There were 4 pure yolk sac tumor cases and four mixed germ cell tumors containing yolk sac tumor element, including two cases with embryonal carcinoma and two cases with embryonal carcinoma and dysgerminoma. Partial vaginectomy was performed in four cases and all patients received chemotherapy. 85 cases in literatures were reviewed and 9 cases were misdiagnosed. Follow-up data was available in 77 cases and 5-year overall survival rate was 87.6%. 5-year survival rate of biopsy with chemotherapy, conservative surgery with chemotherapy and radical surgery with chemotherapy was 91.1%, 100% and 28.6%, respectively (p<0.001). Compared to cases without relapse or metastasis after initial treatment, patients with relapse or metastasis had a shorter overall survival (35.6% vs 96.6%, p<0.001). Conclusions: Mixed germ cell tumor containing yolk sac tumor element was not uncommon and partial vaginectomy may be a good choice for primary vaginal mixed yolk sac tumor type to eradicate local tumor cells and provide complete information for pathological diagnosis and postoperative adjuvant therapy.

Diffuse Embryoma of the Testis - A Case Report -

이원애 대한병리학회 2008 Journal of Pathology and Translational Medicine Vol.42 No.2

Diffuse embryoma of the testis is a very rare, distinct form of mixed germ cell tumor. I report here on a case of diffuse embryoma in a 22-year-old male who presented with painful scrotal swelling. The resected testis was entirely occupied by a non-encapsulated tumor mass. The cut surface of the tumor was grey or whitish pink, soft and granular with foci of hemorrhage and necrosis. Microscopically, the tumor was characterized by a diffuse, orderly arrangement of embryonal carcinoma and yolk sac tumor in almost equal proportions. The yolk sac tumor component was diffusely wrapped around the embryonal carcinoma. Syncytiotrophoblasts were scattered throughout the tumor. Minor foci of immature teratoma, seminoma and intratubular germ cell neoplasia were observed. The yolk sac tumor (YST) component was emphasized by immunoreactivity for alpha fetoprotein, whereas the embryonal carcinoma was reactive for CD30. The strong reactivity for cytokeratin in the YST component formed an outstanding contrast to the weak cytokeratin reactivity in the embryonal carcinoma. Diffuse embryoma of the testis is a very rare, distinct form of mixed germ cell tumor. I report here on a case of diffuse embryoma in a 22-year-old male who presented with painful scrotal swelling. The resected testis was entirely occupied by a non-encapsulated tumor mass. The cut surface of the tumor was grey or whitish pink, soft and granular with foci of hemorrhage and necrosis. Microscopically, the tumor was characterized by a diffuse, orderly arrangement of embryonal carcinoma and yolk sac tumor in almost equal proportions. The yolk sac tumor component was diffusely wrapped around the embryonal carcinoma. Syncytiotrophoblasts were scattered throughout the tumor. Minor foci of immature teratoma, seminoma and intratubular germ cell neoplasia were observed. The yolk sac tumor (YST) component was emphasized by immunoreactivity for alpha fetoprotein, whereas the embryonal carcinoma was reactive for CD30. The strong reactivity for cytokeratin in the YST component formed an outstanding contrast to the weak cytokeratin reactivity in the embryonal carcinoma.

난소의 난황낭종양을 가진 환자에서 bleomycin, etoposide 및 cisplatin의 병합 항암화학요법 후 결과 분석

김지영 ( Ji Young Kim ),신유정 ( Yu Jung Shin ),문제원 ( Jei Won Moon ),박정열 ( Jeong Yeol Park ),김대연 ( Dae Yeon Kim ),이주학 ( Joo Hak Lee ),김종혁 ( Jong Hyeok Kim ),김용만 ( Yong Man Kim ),김영탁 ( Young Tak Kim ),남주현 ( 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.11

Objective: The aim of this study was to evaluate the oncologic and reproductive outcomes of patients with ovarian yolk sac tumor after bleomycin, etoposide, cisplatin (BEP) chemotherapy following surgery. Methods: Of 145 patients with histologically confirmed malignant ovarian germ cell tumor, 43 had yolk sac tumor and received BEP chemotherapy after surgery. A retrospective analysis of these patients was performed. Results: The mean age of 43 patients was 24.8 years (range, 7 to 59 years). Thirty eight patients were nulliparous. Of 179 BEP chemotherapy cycles, grade 1~2 hematologic and non-hematologic adverse events occurred in 46 cycles in 21 patients. Thirty nine patients showed complete remission, 1 patient showed partial remission, and 3 patient had progressive disease during BEP chemotherapy. After median follow-up time of 57 months (range, 3 to 153 months), 5 patients had recurrent disease and three of them died of disease. The 5-year recurrence free survival rate and overall survival rate were 86% and 94%, respectively. After chemotherapy, all but one premenarchal patients had normal menstruation. Of them 5 patients tried to conceive and 3 of them succeeded in pregnancy. Conclusion: BEP chemotherapy was very safe and effective in patients with ovarian yolk sac tumor. Survival outcomes are excellent and reproductive outcomes are promising after BEP chemotherapy.

Primary Yolk Sac Tumor of the Omentum: Case Report

백창규,오영택,정대철,배윤성 대한영상의학회 2012 대한영상의학회지 Vol.66 No.1

A 32-year-old woman had been referred to our hospital for lower abdominal pain. Pelvic ultrasonography and magnetic resonance imaging revealed a huge solid mass with an internal cystic portion. The patient underwent a staging laparotomy and subsequent total abdominal hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic lymph nodes sampling, and total omentectomy. At staging laparoto¬my, a large omental mass was found. The tumor displayed the typical histological patterns observed in the yolk sac tumor. The alpha-fetoprotein (AFP) serum value on the 10th day after surgery was 11,576.67 IU/mL and decreased to 6.46 IU/mL af¬ter chemotherapy. At the end of the treatment, all the findings, including the AFP level, were normal. We report a case of primary yolk sac tumor of the omentum in a 32-year-old woman.

Bowel loop in an ovarian tumor: Grossly visible, completely developed intestinal loop in mature cystic teratoma of malignant mixed germ cell tumor

Kwon, Mi Jung,Nam, Eun Sook,Cho, Seong Jin,Shin, Hyung Sik,Na, Yeon Sik,Chang, Jae Hyuk,Kim, In Sun Blackwell Publishing Asia 2009 Pathology international Vol.59 No.7

<P>Although a gastrointestinal-type epithelium is observed in 7–13% of mature cystic teratoma cases, the occurrence of a grossly visible, organized gastrointestinal loop formation is very rare. Presented here is the case of a 14-year-old girl with malignant mixed germ cell tumor in the ovaries. In her left ovary a grossly visible, intestinal loop, 9 cm long, with hanging mesentery attached to the cystic wall of a mature cystic teratoma associated with a yolk sac tumor was observed, and in her right ovary another mature cystic teratoma was observed. Microscopy of the intestinal loop indicated a well-organized, intact layer of small intestinal wall. The yolk sac tumor predominantly had a polyvitelline pattern. Previously, gastrointestinal wall or epithelium that was identified on microscopy has been reported. To the authors' knowledge this is the first case report of the formation of a grossly visible, completely developed intestinal loop in a malignant mixed germ cell tumor.</P>

Ovarian Endometrioid Adenocarcinoma with a Yolk Sac Tumor Component

정동해,경희은,김나래,하승연,임소이,박상휘,조현이 대한병리학회 2009 Journal of Pathology and Translational Medicine Vol.43 No.6

Ovarian endometrioid adenocarcinoma (EAC) with a yolk sac tumor (YST) component is extremely rare. Only twelve cases have been reported in the English literature. We report here two additional cases of this rare tumor. The YST component showed classic microscopic features, and immunohistochemically stained positive for alpha-fetoprotein (AFP), but negative for cytokeratin 7 (CK7), epithelial membrane antigen (EMA), estrogen receptor (ER) and progesterone receptor (PR). The EAC appeared to blend into the YST in several areas and immunohistochemically stained positive for CK7, EMA, ER, and PR, but negative for AFP.

Case Report : Primary omental yolk sac tumor

( Seon Hwa Lim ),( Yon Hee Kim ),( Ga Won Yim ),( Eun Ji Nam ),( Young Tae Kim ),( Sung Hoon Kim ) 대한산부인과학회 2013 Obstetrics & Gynecology Science Vol.56 No.6

Extra-ovarian yolk sac tumor arising in the omentum is extremely rare. As yolk sac tumor originated from the omentum has been rarely reported, its clinical information is very limited. The authors encountered a case of yolk sac tumor originated from the omentum, and reported the case herein. A 32-year-old woman was presented with developed low abdominal distension for a month. Magnetic resonance imaging findings were suggestive of ovarian malignancy with ascites and peritoneal seeding nodules. Explorative laparotomy was performed and then the findings from frozen biopsy of omentum were suggestive of poorly differentiated tumor though whether it was primary or metastatic was uncertain. Thus, staging laparotomy were performed. Histopathology confirmed that the tumor was a yolk sac tumor of omentum origin. Then, 6 cycles of postoperative adjuvant chemotherapy at intervals of 3 weeks were performed using bleomycin, etoposide, and cisplatin regimen. Four-year outpatient follow-up thereafter showed no relapse.

Primary Pelvic Peritoneal Yolk Sac Tumor in the Post-Pubertal Female: a Case Report with Literature Review

Kim, Myojeong,Lee, Eun Ji,Hwang, Jiyoung,Hong, Seong Sook,Chang, Yun-Woo,Oh, Eunsun,Nam, Bo Da,Choi, Inho,Kim, Jeong Sig Korean Society of Magnetic Resonance in Medicine 2019 Investigative Magnetic Resonance Imaging Vol.23 No.4

Yolk sac tumors are rare malignant germ cell neoplasms that usually arise from the gonads. Extragonadal yolk sac tumors (EGYSTs) frequently occur in the mediastinum in post-pubertal females. EGYSTs in the pelvis are extremely rare, and to date, only thirteen cases have been reported in the English literature. Among them, the primary EGYST of the pelvic peritoneum in post-pubertal females has only been reported in ten cases. The present case describes a 26-year-old female diagnosed with primary peritoneal yolk sac tumor located in the rectouterine pouch. We report clinical and tumor imaging features, including ultrasound, computed tomography (CT), magnetic resonance images (MRI), positron emission tomography-computed tomography (PET-CT), and present a review of the literature.

Primary Pelvic Peritoneal Yolk Sac Tumor in the Post-Pubertal Female: a Case Report with Literature Review

김묘정,이은지,황지영,홍성숙,장윤우,오은선,남보다,최인호,김정식 대한자기공명의과학회 2019 Investigative Magnetic Resonance Imaging Vol.23 No.4

Yolk sac tumors are rare malignant germ cell neoplasms that usually arise from the gonads. Extragonadal yolk sac tumors (EGYSTs) frequently occur in the mediastinum in post-pubertal females. EGYSTs in the pelvis are extremely rare, and to date, only thirteen cases have been reported in the English literature. Among them, the primary EGYST of the pelvic peritoneum in post-pubertal females has only been reported in ten cases. The present case describes a 26-year-old female diagnosed with primary peritoneal yolk sac tumor located in the rectouterine pouch. We report clinical and tumor imaging features, including ultrasound, computed tomography (CT), magnetic resonance images (MRI), positron emission tomography-computed tomography (PETCT), and present a review of the literature.

A sinonasal yolk sac tumor in an adult

신재훈,김지희,정경천,조경자 대한병리학회 2022 Journal of Pathology and Translational Medicine Vol.56 No.3

Yolk sac tumors (YSTs), which are also called endodermal sinus tumors, are malignant tumors of germ cell origin. These tumors usually occur in the gonads, but 20% of cases have been reported at extragonadal sites. The head and neck is a rarely affected region that accounts for just 1% of all malignant tumors of germ cell origin. In addition, YSTs arise mostly in childhood. We present a rare pathologically pure case of primary adult YST in the sinonasal area. A 45-year-old male patient presented with a rapidly growing mass in the nasal cavity, which caused nasal obstruction and bloody post-nasal drip. The histopathologic features indicated pure YST, and immunohistochemical analysis revealed positive reactivity for Sal-like protein 4 and alpha-fetoprotein. Herein, we discuss the clinical, radiologic, and histologic features of this YST and review other cases of sinonasal YST in adults.