T van thielen, department of medical imaging, az klina, brasschaat, brasschaat, belgium, be. She was diagnosed with a pure yst after removing her left ovary. It was first proposed in 1939 by schiller, who discovered an ovarian tumor with a mesonephroid origin. Management and prognosis of ovarian yolk sac tumors. In young patients, this tumor may simulate a yolk sac tumor. This paper reports, for the first time, a complex case of ovarian cs with multiple malignant neoplastic tissue patterns such as mesodermal, neuroectodermal, endodermal, and trophoblastic that are usually derived. Pdf hepatoid yolk sac tumor of the ovary endodermal. Epidemiology ovarian yolk sac tumor is a rare malignant ovarian germ cell tumor that usually occurs around the second decade of life. Mogcts, which include dysgerminomas, immature teratomas, embryonal tumours and endodermal sinus. Ovarian yolk sac tumor is a rare malignant ovarian germ cell tumor that usually occurs around the second decade of life. Nov 01, 2017 yolk sac tumor yst, also known as endodermal sinus tumor, is the second most prevalent mogct histologic subtype following ovarian dysgerminoma.
Scully, md zyxwvu seven cases of ovarian yolk sac tumor endodermal sinus tumor with. Hepatoid variant of yolk sac tumor of both ovaries with. What are the tumor markets for ovarian dysgerminomas. Yolk sac tumors yst are exceedingly rare, malignant nonepithelial, ovarian germcell tumors, the majority being diagnosed in the second and third decade of life. Comparative morphogenesis of the socalled mesoephroma ovarii schiller and extraembryonic yolk sac allantoic structures of the rats placenta.
Apr 08, 2020 yolk sac embryonal choriocarcinoma sometimes mixed consider the 4 main families of ovarian tumors remembering the pentagons can help you remember that there are 5 of each 10% 70% 15% 5%. August 2018 includes ptnm requirements from the 8th edition, ajcc staging manual and 2015 figo cancer report. Yolksac tumors account for about 20% of ovarian germ cell tumors and occur predominantly in women below 35 years of age. Tumor debulking surgery with adjuvant combination chemotherapy is the treatment of choice2,4. Ovarian carcinoma with a somatically derived yolk sac tumor component is a phenomenon known to mostly occur in postmenopausal women. Yolk sac tumor is a rare and aggressive malignancy, representing 20% of germinal tumors in ovary, characterized by its high chemo sensitivity. Ovarian mixed germ cell tumor with yolk sac and teratomatous. It is the most common testicular tumor in children under 3, and is also known as infantile embryonal carcinoma. Immatur teratomdan olusan germ hucreli tumor olgu sunumu. These imaging findings seem to have an important implication for the diagnosis of this tumor. The most common types of nondysgerminomatous tumors are yolk sac tumors ysts. Apr 11, 2018 endodermal sinus tumor yolk sac tumor and choriocarcinoma these very rare tumors typically affect girls and young women. Malignant ovarian germ cell tumor, yolk sac tumor, chemotherapy, ovarian cancer, age, prognostic. Primary endometrial yst is a very rare malignancy, and a primary endometrial yst in the absence of abnormal afp levels is even rarer.
To describe the clinical and sonographic characteristics of malignant ovarian yolk sac tumors ysts. Pdf malignant mullerian mixed tumor of the ovary associated. Yst is a rare malignant tumor comprising about 1% of all malignant ovarian tumors dallenbach et al. Hepatoid variant of yolk sac tumor of ovary is an unusual tumor with an aggressive behavior. High grade serous carcinoma of the ovary with a yolk sac. The critical pathologic features are a smooth external surface and capsular tears due to their rapid rate of growth. Jan 10, 2019 the pathology results of the right ovarian tumor suggested a teratoma and associated mucinous cystadenoma, whereas the intrapelvic tissue sections revealed a mixed germ cell tumor composed of teratoma with somatic type malignancy melanoma and leiomyosarcoma and foci of yolk sac tumor figs. Ct imaging of ovarian yolk sac tumor with emphasis on. Radiotherapy is ineffective in the treatment of yolk sac tumors. Malignant ovarian germ cell tumors mogcts are rare but aggressive, accounting for approximately 1% to 2% of all ovarian malignancies. Pdf to evaluate the clinicopathological prognostic features, factors and outcomes of chemotherapy in ovarian yolk sac tumours yst. The tumor mostly occurs in the 2nd and 3rd decades of life, at an average age of 19 years.
E glandular, papillary yst left originating from well differentiated ovarian endometrioid. Even if the ovarian yolk sac tumor has a good survival rate, the delay in starting chemotherapy and lack of compliance to treatment can give it a poor prognosis, and lead to recurrence or metastasis. Yolk sac tumors were shown as wellenhancing solid tumors on both ct and mr studies and were associated with prominent signal voids on mri. Areas of hemorrhage were another common characteristic. A 27yrold woman presented with abdominal pain, subsequently recognized to be caused by a right ovarian. As opposed to epithelial ovarian cancer nonepithelial ovarian cancer more often affects young women, presents at an early stage, is unilateral involves only one ovary and has a.
Yolk sac embryonal choriocarcinoma sometimes mixed consider the 4 main families of ovarian tumors remembering the pentagons can help you remember that there are 5 of each 10% 70% 15% 5%. Thelatterincludesneoplasmsthat contain teratoma, embryonal, yolk sac, andor choriocarcinoma elements. Yolk sac endodermal sinus tumor is one of the malignant germ cell tumor that usually involves the gonads ovaries and testes. Yolk sac tumor yst or endodermal sinus tumor is the most common malignant germ cell tumor of the testis in children, and is the second most frequent malignant germ cell tumor of the ovary, being. It is the most common testicular tumor in children under 3, 2 and is also known as infantile embryonal carcinoma. They have been observed in women particularly in their early ages, and rarely after 40 years of age. Yolk sac tumors ysts are primitive germ cell neoplasms derived from the embryonic yolk sac, allantois, or extraembryonic mesenchyme and usually develop in the testes or ovaries.
They tend to grow and spread rapidly but are usually very sensitive to chemotherapy. Herein, we report an ovarian endometriosisassociated somatic yolk sac tumor arising in the background of a lowgrade endometrioid adenocarcinoma in a young woman. Apr 30, 2003 yolk sac tumors are second only to dysgerminomas as the most common type of malignant ovarian germ cell neoplasm, and they often occur mixed with other germ cell tumor types. Yolk sac tumor yst of the ovary, also called endodermal sinus tumor, is a subgroup of malignant ovarian germ cell tumors mogct. In this case, the morphologic distinction between these tumors is often difficult but the immunohistochemical staining for ca125 and alpha foeto protein afp and the response to chemoth. Preservation of pregnancy in a patient with acute abdominal. Ovarian yolk sac tumor associated with endometrioid. The term somatic yolk sac tumor has been used to describe tumor associated with an epithelial neoplasm usually high grade, including high grade serous carcinoma, clear cell carcinoma, carcinosarcoma. A hypervascular nature was confirmed on microscopic studies. Scully, md zyxwvu seven cases of ovarian yolk sac tumor endodermal sinus tumor with patterns. Apr 06, 2021 because these markers are more commonly associated with other germ cell tumors ie, yolk sac, embryonal carcinoma, choriocarcinoma, many scientists contend that secreting ovarian dysgerminomas.
In this retrospective multicenter study, we included 21 patients with a histological diagnosis of ovarian yst and available transvaginal ultrasound images andor videoclips andor a detailed ultrasound report. Est of the vagina is a rare, highly malignant gct that exclusively. In the remaining cases, the pattern was thought to be purely yolk sac endodermal sinus, vitel line. The rodent yolk sac is composed of visceral and parietal layers. The classification of international federation of gynecology is the same for nonepithelial neoplasms of ovary. The purpose of this study was to evaluate computed tomographic ct findings of pathologically proven yolk sac tumors of the ovary. For ovarian yolk sac tumors, the reported median age has ranged from to 22 years, and their 5 year overall survival has been found to exceed 85% in most contemporary series 5, 10,11. Evaluation and management of women presenting with a pelvic mass, current obstetrics and. Malignant germcell tumors mgct are rare tumors of childhood accounting for less than 3% of pediatric malignancies. Recurrent ovarian mixed germ cell tumor with unusual.
Molecular characterization of ovarian yolk sac tumor oyst. It should be differentiated from other hepatoid tumors involving the ovary. Primary tumors of the ovary, fallopian tube, or peritoneum version. Ovarian yolk sac carcinoma or endodermal sinus tumor is a rare neoplasm of germ cell origin. Mixed germ cell tumors may secrete bhcg, afetoprotein, or both, depending on the components. Protocol for the examination of specimens from patients with primary tumors of the ovary, fallopian tube, or peritoneum. Eightyeight percent of ovarian germ cell tumors have in. Ovarian tumor, yolk sac, alfafetoprotein, delayed chemotherapy. Yolk sac tumors ysts of the ovary, also known as en dodermal sinus tumors, are the second most common ma lignant ovarian germ cell.
They are typically wellencapsulated round to oval masses. No radiological study has been done to compare the imaging findings between this type of tumor and other ovarian tumors. A yolk sac tumor can be a component of a mixed germ cell tumor, usually dysgerminoma, immature teratoma, and mature teratoma. Somatically derived yolk sac tumor of the ovary in a young w. Yolk sac tumor, also known as endodermal sinus tumor, is a rare malignant gct. Therapeutic strategies for malignant tumors in the second trimester always pose an important dilemma. The clinicopathologic and immunohistochemical findings of an unusual case of ovarian yolk sac tumor associated with endometrioid carcinoma and mucinous cystadenoma of the ovary are reported. Ovarian yolk sac tumor radiology reference article. Evaluation and management of women presenting with a. Malignant ovarian germ cell tumors in postmenopausal patients.
Clear cell carcinoma of the ovary simulating a yolk sac tumor. Endodermal sinus tumor est is a member of the germ cell tumor group of cancers. High grade serous carcinoma is the most common ovarian epithelial malignancy. There are four main types of ogcts, namely dysgerminomas, yolk sac tumor, teratoma, and choriocarcinoma dygerminomas are malignant germ cell tumor of ovary and particularly prominent in patients. Nov 27, 2019 30 year old man with metastatic yolk sac tumor descending from an intraabdominal testis oncol lett 2015. Primary yolk sac tumor originating from the endometrium. Furthermore, embryonal type of differentiation such as yolk sac tumors 8,9 ysts and trophoblast 10,11 have been reported in cs. In females, it is usually encountered in the ovary. Clear cell carcinoma of the ovary simulating a yolk sac. Testicular yolk sac tumor of myxomatous, reticular, and. August 2018 includes ptnm requirements from the 8 th edition, ajcc staging manual and 2015 figo cancer report.
Eighteen instances of ovarian tumor with microscopic pattern similar to that of the testicular tumors which we termed yolk sac or vitelline are presented. Yolk sac tumours of the ovary are rare and highly malignant germ cell tumours, which comprise of only. Yolk sac tumor is an aggressive but a curable disease if diagnosed early and appropriate treatment has been instituted. Pathology and classification of ovarian tumors chen. Pdf en, jump to discussions related content comments powered by disqus. Within 20 months of treatment, conception was achieved. Peccatori et al 11 retrospectively analyzed 129 patients with malignant ovarian germ cell tumors and found that fertilitysparing surgery did not. The most common location of these tumors is the testis or ovary, even though in approximately 1015% of the patients, it arises in extragonadal sites such as the mediastinum, retroperitoneum. Ovarian yolk sac tumor clinical case reports international. Yolk sac tumors international society of ultrasound in. Ovarian germ cell tumors ogcts are heterogeneous tumors that are derived from the primitive germ cells of the embryonic gonad, which accounts for about 2. These tumors commonly develop in infants, young children, and young women and often originate in the gonads. The tumor was detected in a 51yearold postmenopausal woman who presented with abdominal swelling and a pelvic mass. Herein, we report an ovarian endometriosis associated somatic yolk sac tumor arising in the background of a lowgrade endometrioid adenocarcinoma in a young woman.
Yolk sac tumours of the ovary yst, also called endodermal sinus tumours est are rare and highly malignant tumours of utmost importance occurring in children and young adults. Two radiologists retrospectively evaluated ct findings of 10 yolk sac tumors in consensus. In pa tients 2, 6, and 18, the yolk sac tumor was a component of teratoma figs. Management of female malignant ovarian germ cell tumours. Mar 01, 2014 yolk sac tumors can originate from malignant stem cells present in somatic tumors of the ovary and uterus, usually endometrioid adenocarcinoma 51 figure 5, a and carcinosarcoma. Preservation of pregnancy in a patient with acute abdominal pain secondary to advanced and hemorrhagic yolk sac tumor of the right ovary, journal of clinical oncology, 2011.
Pdf chemotherapy of endodermal sinus tumour yolk sac. We report the radiologic and pathologic features of yolk sac tumor endodermal sinus tumor of the ovary in four patients. D hepatic yst of testis with extensive hyaline globule formation. Pure yolk sac tumor of ovary in an adult european journal of. Yolk sac tumors ysts are rare malignant neoplasms of childhood and adolescence and account for 20% of primitive germ cell tumors 1. In japan, between 2003 and 2010, among 35,572 malignant ovarian tumors registered, there. Protocol for the examination of specimens from patients with. Review of ovarian tumors in children and adolescents. Overexpression of isochrome 12p malignant, but responsive to therapy.
Pathology and classification of ovarian tumors chen 2003. The authors present a case report of a 32yearold woman with a history of gradual abdominal distention and an increased serum level of alphafetoprotein afp. Choriocarcinoma that starts in the placenta during pregnancy is more common than the kind that starts in the ovary. Chemotherapy, histopathology, surgery introduction a malignant ovarian tumour was excised and a course of chemotherapy given. It is usually observed in young females, presents with abdominal complaints and is associated with raised. T van thielen, department of medical imaging, az klina, brasschaat, brasschaat, belgium, be x close. Yolk sac tumor is a non dysgerminoma malignancy arising from endodermal sinus, most often unilateral with a diameter of 5 cm to 50 cm, the typical.
Reproductive outcomes of 105 malignant ovarian germ cell tumor. Ovarian yolk sac tumors ysts are the second most common histologic type of ovarian g. Pdf hepatoid yolk sac tumor of the ovary endodermal sinus. Their characteristic immunophenotype helps to differentiate them from. Ovarian yolk sac tumor oyst, also known as endodermal sinus tumor is a rare tumor comprising 1% of all ovarian malignancies. Most patients with malignant ovarian germ cell tumors mogtcs have a very good prognosis and chemotherapy provides curative treatment. Yolk sac tumor yst, also known as endodermal sinus tumor, is the second most prevalent mogct histologic subtype following ovarian dysgerminoma. Pregnancy after excision of a yolk sac tumour of the ovary followed by chemotherapy 1sr ratnapala and 2sd ratnapala index words. Bilateral ovarian mixed epithelial adenocarcinoma in a. Reproductive outcomes and fertility preservation strategies. Yolk sac tumor yst is the second most common tumor in ovarian tumors of this group. Hepatoid yolk sac tumor of the ovary endodermal sinus tumor with hepatoid differentiation a light microscopic, ultrastructural and lmmunohistochemical study z zyxw zyxwzyxwv of seven cases jaime prat, md, atul k. Somatically derived yolk sac tumor of the ovary in a young.
Oysts are rare tumors and promising results are expected with the use of specific therapeutic strategies after the failure of platinumbased firstline and salvage regimens. Yolk sac tumors were shown as wellenhancing solid tumors on both ct and. Yolk sac tumors, also termed endodermal sinus tumors, are believed to develop as a result of differentiation of primitive malignant germ cell elements in the direction of yolk sac or vitelline structures, including embryonal and extraembryonal tissues. Yolk sac tumors ysts are malignant germ cell tumors that secrete alphafetoprotein afp. Yolk sac tumor is a rare tumor encountered in everyday practice and it is even rarer when associated with pregnancy. Yolk sac tumor is usually aggressive, characterized by rapid growth and extensive spread to the abdominopelvic cavity. In the past, outcome was very poor and the disease was almost always fatal.
Successful yolksac tumor treatment with fertilitysparing partial. Malignant ovarian germ cell tumors are often classi. Its identification as a tumor which reproduces yolk sac structures. We report a 6months old girl presented with a vaginal mass diagnosed as a yolk sac tumor. It, yolk sac tumor yst, nongestational choriocarcinoma cc and. Oct 12, 2020 yolk sac tumor prepubertal dermoid cyst usually yolk sac tumor mixed germ cell tumor postpubertal usually 20s30s yes aneuploid frequent gains and losses. Microscopically yst resembles to the extraembryonal yolk sac and vittelline stalk and is diffusely positively for alpha fetoprotein afp 4.
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