Clinicopathological features of ovarian epithelial tumour with yolk sac tumour component

HUO Zhen; LI Wen-qin; MA Shui-qing; GUO Li-na

doi:10.3969/j.issn.1007-8096.2017.12.004

Abstract：Objective To analyze the clinicopathological features of ovarian epithelial tumour with yolk sac tumour component (OETYSC).Methods and Results According to the pathological definition,we summarized 2 OETYSC cases in our hospital (aged 58 years and 61 years,respectively) and 33 cases in literature.Pelvic ultrasound examination showed a large cystic-solid mass in one adnexa,respectively.The maximum diameter was 13.5 cm and 12 cm,respectively,among which the diameter of solid area was 6.1 cm and 6 cm,respectively.Preoperative serum AFP was 219.7 ng/ml and 19000 ng/ml,respectively.2 patients both underwent complete hysterectomy and bilateral salpingooophorectomy.Gross examination showed large ovarian cystic-solid mass with obvious necrosis,and the solid area was grayyellow or gray-brown.Microscopically,2 cases were composed of two tumour components,with hemorrhage and necrosis.One component was malignant ovarian epithelial tumour (clear cell carcinoma and endometrioid carcinoma,respectively),another was yolk sac tumour with reticular pattern,papillary pattern,and S-D body in case 1,and glandular and solid pattern in case 2.Immunohistochemically,CK7 and EMA were both positive in the ovarian cancer component in 2 cases,but AFP and SALL4 were both negative.In the yolk sac component,CK7 and EMA were both negative,and AFP and SALL4 were both positive.Two components were transitional and overlapping.Conclusion OETYSC exists rarely,and mainly in older women.The serum AFP levels often increase with various degrees in the OETYSC patients.The malignant ovarian epithelial components often present.The correct diagnosis depends on the morphology,serum AFP levels and immunohistochemical markers,including CK7,EMA,AFP and SALL4.Accurate postoperative pathological diagnosis is the key to targeted therapy,and phase Ⅱ or above cases have poor prognosis.