Ovarian Carcinosarcoma with Yolk Sac Tumor in a Post-Menopausal Female
A Case Report and Review of Literature
Keywords:carcinosarcoma, yolk sac tumor, ovary, postmenopausal
Yolk sac tumor is the second most common subtype of ovarian germ cell tumors and is rare in postmenopausal
women. The few cases in literature have found that in this age group, yolk sac tumors more commonly present as a mixed component, combined with epithelial tumors. We report a case of a 60-year-old female who presented with an enlarging abdominopelvic mass. Imaging pointed to an ovarian new growth. Total abdominal hysterectomy with bilateral salpingo-oophorectomy revealed a tumor with three populations composed of carcinomatous, sarcomatous, and germ cell components, which was ultimately diagnosed as an ovarian carcinosarcoma with concurrent yolk sac tumor based on histomorphology and immunohistochemical staining. This report also discusses the proposed pathogenesis, treatment, and prognosis of this uncommon entity.
2. Rutgers JL, Young RH, Scully RE. Ovarian yolk sac tumor arising from an endometrioid carcinoma. Hum Pathol. 1987;18(12):1296–9. PMID: 3679203. https://doi.org/10.1016/s0046-8177(87)80418-5.
3. Nogales F, Bergeron C, Carvia R, Alvaro T, Fulwood H. Ovarian endometrioid tumors with yolk sac tumor component, an unusual form of ovarian neoplasm. Analysis of six cases. Am J Surg Pathol.1996;20(9):1056-66. PMID: 8764742. https://doi.org/10.1097/00000478-199609000-00003.
4. Garcia-Galvis OF, Cabrera-Ozoria C, Fernandez JA, et al. Malignant Mullerian mixed tumor of the ovary associated with yolk sac tumor, neuroepithelial and trophoblastic differentiation (teratoid carcinosarcoma). Int J Gynecol Pathol 2008; 27:515–20. PMID: 18753971. https://doi.org/10.1097/PGP.0b013e31817b06c7.
5. Fadare O, Shaker N, Alghamdi A, et al. Endometrial tumors with yolk sac tumor-like morphologic patterns or immunophenotypes: an expanded appraisal. Mod Pathol. 2019;32(12):1847-60. PMID: 31375771. https://doi.org/10.1038/s41379-019-0341-6.
6. Roth LM, Talerman A, Levy T, Sukmanov O, Czernobilsky B. Ovarian yolk sac tumors in older women arising from epithelial ovarian tumors or with no detectable epithelial component. Int J Gynecol Pathol. 2011;30(5):442-51. PMID: 21804392. https://doi.org/10.1097/PGP.0b013e3182164386.
7. McNamee T, Damato S, McCluggage WG. Yolk sac tumours of the female genital tract in older adults derive commonly from somatic epithelial neoplasms: somatically derived yolk sac tumours. Histopathol. 2016;69(5):739–51. PMID: 27334714. https://doi.org/10.1111/his.13021.
8. Ahn H, Oh MH, Cho HD, et al. Ovarian yolk sac tumor with epithelial tumor component in a postmenopausal woman - case report and literature review. Int J Clin Exp Pathol. 2020;13(9):2401–6. PMID: 33042351. PMCID: PMC7539866.
9. Rabban JT. Distinction of low-grade endometrioid carcinoma in endometrial samplings from high-grade mimics: a practical pattern-based approach. Diagn Histopathol. 2020;26(6):237-47.
10. Boussios S, Attygalle A, Hazell S, et al. Malignant ovarian germ cell tumors in postmenopausal patients: The Royal Marsden experience and literature review. Anticancer Res. 2015;35(12):6713-22. PMID: 26637887.
11. Nogales FF, Preda O, Nicolae A. Yolk sac tumours revisited. A review of their many faces and names. Histopathology. 2012;60(7):1023-33. PMID: 22008025. https://doi.org/10.1111/j.1365-2559.2011.03889.
12. Roma AA, Przybycin CG. Yolk sac tumor in postmenopausal patients: pure or associated with adenocarcinoma, a rare phenomenon. Int J Gynecol Pathol. 2014;33(5):477-82. PMID: 25083963. https://doi.org/10.1097/PGP.0000000000000078.
13. Taranto P, Carvalho FM, Roithmann S, Maluf FC. Ovarian yolk sac tumor coexisting with epithelial ovarian cancer: an aggressive rare entity. Gynecol Oncol Rep. 2017;22:37-9. PMID: 29204510. PMCID: PMC5689461. https://doi.org/10.1016/j.gore.2017.09.004.
14. Lopez JM, Malpica A, Deavers MT, Ovarian yolk sac tumor associated with endometrioid carcinoma and mucinous cystadenoma of the ovary. Ann Diagn Pathol. 2003;7(5):300–5. PMID: 14571433. https://doi.org/10.1016/s1092-9134(03)00081-9.
15. Wang Y, Yang J, Yu M, et al. Ovarian yolk sac tumor in postmenopausal females: a case series and literature review. Medicine (Baltimore). 2018;97(33):e11838. PMID: 30113473. PMCID: PMC6112915. https://doi.org/10.1097/MD.0000000000011838.
16. Del Carmen MG, Birrer M, Schorge JO. Carcinosarcoma of the ovary: a review of the literature. Gynecol Oncol. 2012;125(1):271–7. PMID: 22155675. https://doi.org/10.1016/j.ygyno.2011.12.418.
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