Somatically Derived Yolk Sac Tumor of the Ovary in a Young Woman

Anjelica Hodgson, Zeina Ghorab, Carlos Parra-Herran, Carlos Parra‐Herran
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2020 · vol. 40(3) , pp. 296–300 · doi:10.1097/pgp.0000000000000673 · PMID:32209818 · W3014016523
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Abstract

Ovarian carcinoma with a somatically derived yolk sac tumor component is a phenomenon known to mostly occur in postmenopausal women. Herein, we report an ovarian endometriosis-associated somatic yolk sac tumor arising in the background of a low-grade endometrioid adenocarcinoma in a young woman. A 27-yr-old woman presented with abdominal pain, subsequently recognized to be caused by a right ovarian mass undergoing torsion. Following operative management, microscopic examination of the salpingo-oophorectomy specimen showed endometriosis and a predominantly cystic ovarian neoplasm with 2 distinct phenotypic areas: (1) a yolk sac tumor component containing Schiller-Duval bodies and (2) a low-grade endometrioid carcinoma component with squamous metaplasia. Immunohistochemical evaluation showed distinct profiles in the yolk sac tumor (estrogen receptor/progesterone receptor/PAX8 negative, SALL4/Glypican 3 positive) and endometrioid (estrogen receptor/progesterone receptor/PAX8 positive, SALL4/Glypican 3 negative) components. Given these findings, the diagnosis of an endometriosis-associated endometrioid adenocarcinoma with a somatically derived yolk sac tumor was rendered. The tumor was staged as pT1c1 due to intraoperative spillage. The patient underwent chemotherapeutic treatment and after 15 mo of follow-up, she was alive with no evidence of recurrence. This example demonstrates that somatic yolk sac tumor differentiation in ovarian epithelial neoplasia can occur in young patients; awareness of this phenomenon is important as somatic and germ cell yolk sac neoplasia have different behavior and therapy.

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Condition tags

endometriosis

MeSH descriptors

Biomarkers, Tumor Carcinoma, Endometrioid Endodermal Sinus Tumor Endometriosis Ovarian Cysts Ovarian Neoplasms Adult Biomarkers, Tumor Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Endodermal Sinus Tumor Endodermal Sinus Tumor Endodermal Sinus Tumor Endometriosis Endometriosis Endometriosis Female Humans Immunohistochemistry

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