Primary Yolk Sac Tumor of the Endometrium-----A Case Report and Literature Review

Abstract BackgroundPrimary yolk sac tumor (YST) of the endometrium is extremely rare. We report a case of endometrial YST and review the literature to provide a comprehensive understanding of the diagnosis and management of primary YST of the endometrium.Methods A 43-year-old woman with primary YST of the endometrium is described. We summarize the clinical characteristics, treatments and prognosis of the case reported herein and 29 cases from the literature.ResultsIn a total of 30 primary endometrial YSTs, the average patient age was 52 years (range, 24-87 y). The mean tumor size was 6.94 cm (range 1.3-19.0 cm). Increasing serum levels of AFP were observed in all but one patient. Stage I was more common (12/30, 40%), followed by stages II (5/30, 17%), III (6/30, 20%) and IV (7/30, 23%). Of all 30 patients, 17 (57%) had pure endometrial YST, and 13 (43%) had a concomitant somatic neoplasm representing between <10% and 90% of the tumor, of which endometrial adenocarcinoma was the most common. Patients with pure YST were younger than those with concomitant somatic tumors (ranging from 24-68 years, mean 44.41 years vs. range 28-87 years, mean 61.92 years, P=0.008). Endometrial YSTs with somatic neoplasms had a poorer prognosis than pure YSTs.ConclusionPrimary YST of the endometrium is an extremely rare disease. Surgery combined with adjuvant chemotherapy is the most effective treatment. A late stage and combined somatic components may indicate a poor prognosis.