Primary mediastinal yolk sac tumor:a report of 4 cases and review of literature
XU Cun-bao
SU Chun-yang
YAO Xi-hu
ZHANG Feng-shun
WANG Yi-xuan
CHEN Yi-feng
Abstract：Objective To investigate the clinicopathological features,diagnosis,differential diagnosis and prognosis of primary mediastinal yolk sac tumors(PMYST).Methods A retrospective analysis of clinical data from four cases of mediastinal yolk sac tumors was performed.HE staining and the immunohistochemical EnVision two-step method were used to analyze the clinicopathological characteristics,and a review of related domestic and international literature was conducted.Results The tumors exhibited a mixture of growth patterns,including reticular,microcystic,and endodermal sinus structures.Tumor cells had large,vacuolated nuclei with prominent nucleoli,and eosinophilic hyaline globules were observed in the cytoplasm.Immunohistochemically tumor cells expressed SALL4,AE1/AE3,GPC-3,and HNF1β,with variable expression of AFP,CD117,PLAP,and EMA,and negative expression of CD30,OCT3/4,and D2-40.The Ki-67 index was 60%-70%.This case series,along with a review of the literature encompassing 48 cases,showed a follow-up period ranging from 1 to 144 months,with 20 deaths.The survival curve indicated that all deaths occurred within approximately 2 years.Conclusion PMYST is a rare and highly malignant germ cell tumor that predominantly affects young and middle-aged men,with a high mortality rate within 2 years.Serum AFP levels are helpful for diagnosis,monitoring therapeutic response,and detecting tumor recurrence.Treatment primarily involves surgery and chemotherapy,with the latter being effective.
Keywords：MediastinumGerm cell tumorYolk sac tumorAFP
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1031-1036 )