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Primary yolk sac tumor of the endometrium: a case report and review of the literatures

Archives of Gynecology and Obstetrics volume 300, pages 1177–1187 (2019)Cite this article

Abstract

Purpose

Yolk sac tumor (YST) is a malignant tumor derived from germ cells and usually occurs in the gonads. Extra-gonadal YST is most commonly seen in the vagina of children, but rarely in the cervix, vulva and endometrium. Primary YST of endometrium was extremely rare, standard treatment was still controversial and no guideline was established so far. The aim of the present study was to provide a comprehensive understanding and systematic thought for the management of primary YST of endometrium.

Methods

A systematic research of the literature was conducted in Scopus, PubMed database and Cochrane Library, including case reports and case series. We summarized clinical characteristics, treatments and prognosis of all collected cases. We collected data regarding patients, serum AFP level, initial symptoms, surgical information, postoperative chemotherapy and radiotherapy. A new case was also discussed.

Results

We found only 26 cases have been reported previously. We reported a new case of primary endometrial YST in a 27-year-old woman, and in this case, we creatively performed bilaterally ovarian preservation and used DC (docetaxel and carboplatin) regimen of postoperative chemotherapy, we achieved a relatively good prognosis during the follow-up period of 14 months.

Conclusion

Primary YST of endometrium, kind of highly malignant germ cell tumors, was extremely rare, of which initial symptom is usually abnormal vaginal bleeding. Standard treatment was still controversial and no guideline was established so far. Surgery combining with postoperative chemotherapy was considered effective for treatment of primary endometrial YST. Decision on whether to preserve ovaries in young patient with early stage needs careful consideration, comprehensive preoperative assessment and full communication. Intraoperative biopsy and strict postoperative follow-up are recommended. However, standard chemotherapy regimen and feasibility of postoperative radiotherapy remains to be discussed.

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Funding

This study was funded by Qilu Hospital of Shandong University in China.

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Affiliations

  1. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People’s Republic of China

    Tao Lu, Liping Qi, Yanhui Ma, Guojiao Lu, Xiaolei Zhang & Peishu Liu

Authors
  1. Tao Lu
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  2. Liping Qi
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  3. Yanhui Ma
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  4. Guojiao Lu
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  5. Xiaolei Zhang
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  6. Peishu Liu
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Contributions

TL: data collection, data analysis, formal analysis and manuscript writing/editing. LQ: data collection, formal analysis and manuscript writing. YM: paper assessment. GL: formal analysis. XZ: manuscript revising. PL: manuscript revising. Tao Lu and Liping Qi contributed equally.

Corresponding authors

Correspondence to Xiaolei Zhang or Peishu Liu.

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The authors report no conflict of interest.

Ethical approval

All the procedures performed in studies involving human participants were in accordance with the ethical standards of Ethics Committee of Qilu Hospital of Shandong University and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The publication of this case report got permission of the patient.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent for publication of this case report was received and personally signed from the patient on 2019-4-10.

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Lu, T., Qi, L., Ma, Y. et al. Primary yolk sac tumor of the endometrium: a case report and review of the literatures. Arch Gynecol Obstet 300, 1177–1187 (2019). https://doi.org/10.1007/s00404-019-05309-3

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  • DOI: https://doi.org/10.1007/s00404-019-05309-3

Keywords

  • Yolk sac tumor
  • Endodermal sinus tumor
  • α-Fetoprotein
  • Ovarian preservation
  • Endocrine function preservation
  • Endometrium