A case of mixed ovarian cancer, adenocarcinoma and probably somatically derived yolk sac tumor

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  • 体細胞由来と考えられる上皮性卵巣腫瘍と卵黄囊腫瘍の混合腫瘍の1例
  • タイサイボウ ユライ ト カンガエラレル ジョウヒセイ ランソウ シュヨウ ト ランオウノウ シュヨウ ノ コンゴウ シュヨウ ノ 1レイ

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Abstract

Yolk sac tumors (YSTs) are malignant germ cell tumors that usually form in young women. We report a rare case of somatic YST with epithelial neoplasm in a 62-year-old postmenopausal patient. MRI and CT detected a multilocular cystic mass with an enhancing solid lesion in the right ovary and peritoneal dissemination. Preoperative serum tumor marker (CEA, CA-125 and AFP) concentrations were elevated. Debulking surgery was performed, but most of the lesions remained. In a pathological examination, the right ovarian tumor showed adenocarcinoma and YST components. The adenocarcinoma displayed columnar mucous atypical cells, and immunohistochemical staining was positive for alcian blue, and negative for SALL4, AFP, and glypican-3. The YST showed cuboidal atypical cells with a clear cytoplasm, and immunohistochemical staining was positive for SALL4, AFP, and glypican-3, and negative for napsin A. Postoperatively, the patient started BEP chemotherapy, and terminated it on the third day of the first course owing to her poor physical condition and renal dysfunction. She died on the 46th postoperative day because of rapid disease progression. Our findings suggest that postmenopausal women might have a YTS associated with an epithelial neoplasm, and this requires prompt diagnosis and treatment. [Adv Obstet Gynecol, 75(3) : 322-329, 2023 (R5.8)]

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