原发子宫内膜卵黄囊瘤1例并文献回顾

Primary yolk sac tumor of the endometrium:a case report and literature review

目的提高对原发子宫内膜卵黄囊瘤(yolk sac tumor,YST)临床及病理学特征的认识。方法报告南通市肿瘤医院2020年5月诊断YST 1例,收集病人相关临床信息包括血清甲胎蛋白(AFP)水平、手术方案、化学治疗方案及术后随访20个月。并复习原发子宫内膜YST相关文献。结果原发性子宫内膜YST 1例,采取全子宫加双侧附件切除手术、网膜切除术及盆腔淋巴结清扫术,并在术后化疗接受BEP(博来霉素,依托泊苷和顺铂)治疗方案,随访20个月,病人预后佳。结论原发性子宫内膜YST是一种罕见高度恶性的生殖细胞肿瘤,迄今为止尚未有共识性治疗方案。手术治疗联合术后化疗被认为是治疗原发性子宫内膜YST的有效方法。术后随访血清AFP水平可用于监测治疗结果以及检测治疗后的转移和复发。

Objective To improve the understanding of clinical and pathological features of primary endometrial Yolk Sac Tumor(YST).Methods One patient with YST who was diagnosed in Nantong Tumor Hospital in May 2020 was reported,the relevant clinical information of the patient,including serum AFP levels,surgical plan,chemotherapy plan,and postoperative follow-up for 20 months were collected.And the relevant literature on primary endometrial YST was reviewed.Results One case of primary endometrial YST was treated with total hysterectomy plus bilateral adnexectomy,epiploidectomy and pelvic lymph node dissection,and bleomycin,etoposide and cisplatin(BEP)after postoperative chemotherapy.The patient achieved a relatively good prognosis during the follow-up period of 20 months.Conclusion Primary endometrial YST is a rare highly malignant germ cell tumor,so far there is no consensus treatment plan.Surgical treatment combined with postoperative chemotherapy is considered to be an effective method for treating primary endometrial YST.Serum AFP levels at postoperative follow-up can be used to monitor the treatment outcome and detect metastasis and relapse after treatment.