Clinicopathologic Characteristics and Survival of Patients with Rare Malignant Ovarian Yolk Sac Tumors:A Population-based Analysis

Yolk sac tumors (YSTs) are rare malignant germ cell tumors that usually affect youngfemales. To date, there have been few studies on YSTs. We evaluated the relationship betweenclinicopathologic characteristics of patients with ovarian YSTs and disease outcome based onSurveillance, Epidemiology, and End Results data. The K aplan-Meier method and log-rank testwere used to evaluate differences in survival rates. Data for 269 patients were analyzed. Theincidence of YSTs among ovarian germ cell tumors (OGCTs) cases was 0.4%;median patient agewas 22.0 years, and most tumors were unilateral. Patients presented with distant metastasis (37.5%),localized disease (49. 1%), and regional spread (8.9%). American Joint Committee on Cancer stagewas available for 13 patients (stage IA, n=2;stage IC, n=1;stage IA, n=1;stage IB, n=3;stageIlC, n=2;and stage IV, n=4). Survival rates at 1, 3, and 5 years were 91.0%, 84.0%, and 83.2%,respectively, for overall survival (OS) and 92.0%, 85.4%, and 84.5%, respectively, for disease-specific survival (DSS). The 5-year OS and DSS of patients with ovary tumors were 91.5% and92.9%, respectively, compared to 74.8% and 77.2%, respectively, for those with extra-ovarianspread (P<0.001 for both OS and DSS). Age >50 years was associated with shorter OS and DSS(both P<0.001), whereas no associatios of OS and DSS were observed with pathologic grade (P=0.49for OS and 0.52 for DSS). In summary, YSTs are typically unilateral, of a high grade, and localizedto the ovary;extra-ovarian spread has a poor outcome, and postmenopausal women have worseprognosis than premenopausal women.

Primary yolk sac tumor in the abdominal wall in a 20-year-old woman:A case report

BACKGROUND Extragonadal yolk sac tumors(YSTs)are rare,with only a low reported tumor occurrence outside the gonads locally and abroad.Extragonadal YSTs are usually a diagnostic challenge,because they are infrequent,but also because a thoughtful and detailed differential diagnostic process must be performed.CASE SUMMARY Here we present a case of an abdominal wall YST in a 20-year-old woman admitted with a tumor in the lower abdomen close to the umbilicus.The tumorectomy was performed.The histological examination revealed characteristic findings such as Schiller-Duval bodies,loose reticular structures,papillary structures,and eosinophilic globules.According to the immunohistochemical staining,the tumor tissue was positive for broad-spectrum cytokeratin,Spalt-like transcription factor 4,glypican-3,CD117,and epithelial membrane antigen.Based on the clinical information,histological features,and immunohistochemical staining profile,the tumor was diagnosed as a YST present in the abdominal wall.CONCLUSION Based on the clinical information,histological features,and immunohistochemical staining profile described above,the tumor was diagnosed as a primary YST in the abdominal wall.

Refractory Ascites Revealing an Ovarian Yolk Sac Tumor with Intraperitoneal Rupture

Yolk sac tumors of the ovary are rare entities that account for 2% - 5% of all ovarian tumors. They represent the second most common histological variant of malignant germ cell tumors of the ovary after dysgerminomas. Yolk sac tumors are most commonly encountered in women in the second and third decades. Microscopically, they are highly polymorphic and can present in a pure form or associated with another contingent of germ cell tumor. We report the case of a 26-year-old woman, who underwent surgery for a large right ovarian tumor rupturing into the peritoneal cavity. The ovarian tumor was revealed by ascites of great abundance and abdomino-pelvic pain. On histological examination, the diagnosis of yolk sac tumor in its pure and polyvesicular vitelline pattern was made. Through this observation, we propose to discuss the anatomoclinical particularities of these tumors by emphasizing the importance of histology for the diagnosis as well as the need of an early and appropriate management.

A case report of primary mediastinal yolk sac tumor

Primary yolk sac tumor of the mediastinum is very rare. Yolk sac tumor is highly malignant, and has less chance of operation. One case, which treated in this institute since 1954, is retrospectively studied to investigate the clinical characteristics, surgical treatment and prognosis of the primary mediastinal yolk sac tumor.

Yolk Sac Tumor and Fanconi Anemia: Case Report

Yolk sac tumor (YST), which most frequently arises in the gonads as a type of germ cell tumor, is rare in children but is highly malignant. The common age group affected by yolk sac tumours is 11 to 24 years. In this study, we described a rare case of YST in terms of the clinical manifestation, imaging, and histopathology findings, diagnosis and treatment in a 12-year-old girl who was followed since birth for Fanconi-like syndrome. This is a rare clinical association that also limits chemotherapy.

Yolk Sac Tumor of the Ovary in 18 Egyptian Cases: Does It Really Differ?

Background: Ovarian Yolk sac tumor (OYST) is a rare entity of malignant ovarian germ cell tumors (MOGCT). Abdominal pain, a rapidly growing distending mass or irregular vaginal bleeding is the main presentation. Serum AFP is elevated in nearly all cases. The standard management is fertility preserving surgery with adjuvant chemotherapy. Aim of Work: To report and analyze retrospectively recorded cases that were either treated at National Cancer Institute/Egypt or referred there for advice about therapy. Materials and Methods: This is a retrospective single-institutional analysis of 18 cases of OYST treated at National Cancer Institute-Cairo University from January 2011 till December 2015. The clinical and pathological characteristics, treatment, and outcomes of these patients were analyzed. Results: Data from eighteen patients were obtained. The median age was 18 years (range: 15 - 22). Abdominal pain was the most common presentation (89%). The mean tumor size was 21cm (range: 8 - 30 cm). Eleven of our cases (61%) were stage I, seven cases and (39%) were stage IV at presentation. Fifteen cases (83%) underwent fertility preserving procedure & the standard surgical staging. Panhysterectomy & formal staging procedure was done only in two cases (11%). One case (6%) underwent bilateral salpingo-oophorectomy. 2 cases (11.1%) only underwent lymph node biopsy. 11 patient (61.1%) showed pure type YST while mixed type was present in the remaining 7 cases (38.8%): Dysgerminoma (one case, 5.6%), Dysgerminoma + immature teratoma (one case, 5.6%), Immature teratoma (2 cases, 11.1%) and Teratoma (3 cases, 16.7%). AFP was extremely elevated in all cases at presentation (median 4191 ng/mL;ranging: 725 ng/mL - 402,908 ng/mL). It showed decreased level after surgery (median 145 ng/ mL;ranging: 2 ng/mL - 38,000 ng/mL) & normalized after chemotherapy except for progressive disease. All cases started BEP regimen after surgery with complete remission in twelve cases. In follow up period (median 17 months;ranging: 2 - 48 months) two patients relapsed;the mean overall survival time was 34.2 and progression free survival was 33.84 months respectively. Conclusion: Ovarian yolk sac tumors are rare neoplasms. Surgery with adjuvant chemotherapy is the standard management. AFP is important for diagnosis, monitoring response to treatment and predicting relapse.

Laparoscopic uncontained power morcellation-induced dissemination of ovarian endodermal sinus tumors:A case report

BACKGROUND Endodermal sinus tumors(ESTs),which arise primarily in children and adolescents,account for 20%of malignant ovarian germ cell tumors,but constitute only 1%of all ovarian malignancies.Treatment of ESTs consists of surgical staging with fertility-sparing surgery and chemotherapy.CASE SUMMARY A 15-year-old nulliparous patient was diagnosed with disseminated ovarian ESTs after laparoscopic unilateral salpingo-oophorectomy using uncontained power morcellation for treatment of a ruptured solid adnexal mass in another hospital.Exploratory laparotomy;total abdominal hysterectomy,right salpingooophorectomy,and lymphadenectomy were performed with optimal debulking,and surgical stage 3C was assigned to the patient.CONCLUSION In 2014,the Food and Drug Administration noted that power morcellation was probably associated with a risk of disseminating suspected cancerous tissue.Furthermore,the use of power morcellation to remove solid adnexal mass is considered a contraindication because of the potential for a malignant tumor.This case report aims to warn of the dangers of using uncontained power morcellation to treat solid adnexal masses.

Non-seminomatous germ cell tumor with bone metastasis only at diagnosis:A rare clinical presentation

Bone metastasis of non-seminomatous germ cell tumors(NSGCT)of the testes is a rare event and even more uncommon at initial presentation.Generally,bone lesions are discovered in the presence of concurrent retroperitoneal lymph node or visceral disease.However,in this case,a 37 years old male complaining of a growing testicular mass was found to have isolated bone metastasis with associated caudaequina syndrome without apparent abnormal findings on initial computed tomography(CT)scans.Continued neurologic symptoms prompted further evaluation with magnetic resonance imaging(MRI),which demonstrated multiple sites of bone metastasis without evidence of retroperitoneal lymph node or visceral organ involvement.This case represents a rare clinical presentation and disease manifestation of NSGCT.