Female ; Humans ; Endodermal Sinus Tumor/pathology* ; Adenocarcinoma/pathology* ; Choriocarcinoma/pathology*

Endodermal Sinus Tumor ; Female ; Humans ; Mixed Tumor, Malignant ; Neoplasms, Germ Cell and Embryonal ; Teratoma/pathology* ; Uterus/pathology*

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.
Carcinosarcoma ; Endodermal Sinus Tumor ; Ovary

Yolk sac tumors are rare malignant germ cell neoplasms that usually arise from the gonads. Extragonadal yolk sac tumors (EGYSTs) frequently occur in the mediastinum in post-pubertal females. EGYSTs in the pelvis are extremely rare, and to date, only thirteen cases have been reported in the English literature. Among them, the primary EGYST of the pelvic peritoneum in post-pubertal females has only been reported in ten cases. The present case describes a 26-year-old female diagnosed with primary peritoneal yolk sac tumor located in the rectouterine pouch. We report clinical and tumor imaging features, including ultrasound, computed tomography (CT), magnetic resonance images (MRI), positron emission tomography-computed tomography (PET-CT), and present a review of the literature.
Adult ; Douglas' Pouch ; Electrons ; Endodermal Sinus Tumor ; Female ; Gonads ; Humans ; Magnetic Resonance Imaging ; Mediastinum ; Neoplasms, Germ Cell and Embryonal ; Pelvis ; Peritoneum ; Ultrasonography ; Yolk Sac

OBJECTIVE: Primary mediastinal yolk sac tumor, which is also known as endodermal sinus tumor, is a rare but lethal neoplasm and its prognosis is very dismal. The current treatment for this tumor is controversial, and chemotherapy combined with resection of residual lesions is adopted sometimes. We summarized the experience of seven primary mediastinal yolk sac tumors treated with platinum-based chemotherapy and extended resection in Peking University First Hospital. METHODS: Clinicopathological data of the patients with primary mediastinal yolk sac tumor who received operation in Peking University First Hospital between August 2014 and August 2018 were collected and analyzed retrospectively. RESULTS: We experienced seven primary mediastinal yolk sac tumors during this period. Computed tomography scan revealed an anterior mediastinal tumor in all the patients and all of them had markedly raised alphafetoprotein (AFP) and normal β-human chorion gonadotropin (β-HCG). Five patients underwent needle core biopsy before treatment, which showed a mediastinal yolk sac tumor. All of these patients received preoperative platinum-based chemotherapy and they all presented partial response according to computed tomography. Two other patients did not receive preoperative biopsy, so they directly underwent extended resection. All of the seven patients underwent operation successfully and two of them experienced postoperative complications, including one with pneumonia and the other with atelectasis. R0 resection was achieved in six patients and R1 resection was achieved in the other patient. According to postoperative pathology, there were one microcyst subtype, one adenoid subtye, one giant capsule subtype and two hybrid subtypes. Surprisingly, there were no yolk sac tumor tissue in the other two patients after preoperative chemotherapy. All the patients received postoperative chemotherapy, excluded one patient who was unable to tolerate chemotherapy after operation. Three patients experienced postoperative pulmonary metastases within one year and two of them died soon. The other patient received chemotherapy and immunotherapy after recurrence and he was alive at the time of writing. Four other patients were alive without recurrence and metastasis. CONCLUSION Primary mediastinal yolk sac tumor is rare and its prognosis is poor. A multimodality approach including adjuvant chemotherapy and resection of residual lesions is the optimal treatment and it may lead to long-term survival.
Endodermal Sinus Tumor ; Humans ; Male ; Mediastinal Neoplasms ; Mediastinum ; Neoplasm Recurrence, Local ; Retrospective Studies

Endodermal Sinus Tumor/surgery* ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Orchiectomy/methods* ; Teratoma/surgery* ; Testicular Neoplasms/surgery* ; Testis/surgery* ; Treatment Outcome

Thymic adenocarcinoma is extremely rare. Although its histologic features have been occasionally reported, a lack of description of the cytologic features has hampered the prompt and accurate diagnosis of this condition. Herein, we describe the cytologic findings and histology of four aspiration cytology specimens of thymic adenocarcinoma. The specimens were obtained from primary tumors, metastatic lymph nodes, and pericardial effusions. All four specimens showed three-dimensional glandular clusters with a loss of polarity and nuclear overlapping. One specimen had extensive extracellular mucinous material. Three specimens contained tumor cells with intracytoplasmic vacuoles. While the specimen with extracellular mucin showed relatively mild cytologic atypia, other specimens exhibited more atypical cytologic changes: irregular nuclear membranes, a coarse chromatin pattern, and prominent nucleoli. The cytologic features were correlated with the histologic features in each case of enteric type thymic adenocarcinoma. The differential diagnosis included other thymic carcinomas, yolk sac tumors, and metastatic adenocarcinoma from the lung or colorectum.
Adenocarcinoma* ; Biopsy, Fine-Needle* ; Chromatin ; Diagnosis ; Diagnosis, Differential ; Endodermal Sinus Tumor ; Lung ; Lymph Nodes ; Mediastinum ; Mucins ; Nuclear Envelope ; Pericardial Effusion ; Thymoma ; Thymus Gland ; Vacuoles

ObjectiveTo study the pathological morphology, immunohistochemical characteristics, and molecular changes of type Ⅱ testicular germ cell tumors (TGCT) and investigate the possible value of immunohistochemistry and fluorescence in situ hybridization (FISH) in the diagnosis of TGCT.

METHODSWe collected for this study 97 cases of TGCT, including 75 cases of seminoma, 17 cases of embryonal carcinoma, 11 cases of yolk sac tumor, 16 cases of mature teratoma, 3 cases of immature teratoma, and 1 case of epidermoid cyst, in which normal testicular tissue was found in 20 and non-TGCT in 6. We detected the expressions of different antibodies in various subtypes of TGCT by immunohistochemistry and determined the rate of chromosome 12p abnormality using FISH.

RESULTSThe immunophenotypes varied with different subtypes of TGCT. SALL4 and PLAP exhibited high sensitivity in all histological subtypes. CD117 and OCT4 showed strongly positive expressions in invasive seminoma and germ cell neoplasia in situ (GCNIS) but not in normal seminiferous tubules. GPC3 was significantly expressed in the yolk sac tumor, superior to GATA3 and AFP in both range and intensity. CKpan, OCT4, and CD30 were extensively expressed in embryonal carcinoma, while HCG expressed in choriocarcinoma. The positivity rate of isochromosome 12p and 12p amplification in TGCT was 96.7% (29/30).

CONCLUSIONSThe majority of TGCT can be diagnosed by histological observation, but immunohistochemical staining is crucial for more accurate subtypes and valuable for selection of individualized treatment options and evaluation of prognosis. Chromosome 12p abnormality is a specific molecular alteration in type Ⅱ TGCT, which is useful for ruling out other lesions.

Biomarkers, Tumor ; metabolism ; Carcinoma, Embryonal ; diagnosis ; genetics ; metabolism ; pathology ; Chromosome Aberrations ; Chromosomes, Human, Pair 12 ; Endodermal Sinus Tumor ; diagnosis ; genetics ; metabolism ; pathology ; Genetic Markers ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Male ; Neoplasms, Germ Cell and Embryonal ; diagnosis ; genetics ; metabolism ; pathology ; Prognosis ; Seminiferous Tubules ; metabolism ; Seminoma ; diagnosis ; genetics ; metabolism ; pathology ; Teratoma ; diagnosis ; genetics ; metabolism ; pathology ; Testicular Neoplasms ; diagnosis ; genetics ; metabolism ; pathology

OBJECTIVETo investigate different treatment methods for stage-Is testicular mixed germ cell tumors (TMGCTs).

METHODSWe retrospectively analyzed the clinical data about 3'cases of stage-Is TMGCTs (aged 26-39 years) treated in the 175th Hospital of PLA, reviewed relevant literature, and explored the clinical characteristics of TMGCTs.

RESULTSOf the 3 patients, 1 was treated by radical orchiectomy, 1 by radical orchiectomy + retroperitoneal lymph node dissection + BEP chemotherapy scheme, and the other by radical orchiectomy + radiotherapy. The pathological components of TMGCTs were immature teratoma, seminoma, spermatocytoma, chorioepithelioma, embryonal carcinoma, and yolk sac tumor. No recurrence or distant metastasis was found during the 24-month follow-up after surgery.

CONCLUSIONThe diagnosis of TMGCTs primarily depends on physical examination, ultrasonography, MRI, and measurement of serum tumor markers, while its confirmation necessitates pathological examination, and its treatment is basically radical orchiectomy.

Adult ; Carcinoma, Embryonal ; pathology ; Endodermal Sinus Tumor ; pathology ; Humans ; Lymph Node Excision ; Male ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neoplasms, Germ Cell and Embryonal ; pathology ; surgery ; Orchiectomy ; Retrospective Studies ; Seminoma ; pathology ; Teratoma ; pathology ; Testicular Neoplasms ; pathology ; surgery

A case of primary yolk sac tumor of endometrium was retrospectively analyzed and relevant literature was systematically reviewed. We found that the primary yolk sac tumor of endometrium showed low incidence rate and was clinically characterized by abnormal vaginal bleeding, intrauterine lesions and significantly elevated alpha-fetoprotein (AFP) level. The final diagnosis should be confirmed by pathological examination. There is no guideline for the treatment of primary yolk sac tumor of endometrium due to its rareness. For now, surgery and chemotherapy are the major therapies and the curative effect is satisfactory in some cases.
Endodermal Sinus Tumor ; diagnosis ; epidemiology ; therapy ; Female ; Humans ; Incidence ; Retrospective Studies ; Uterus ; pathology ; alpha-Fetoproteins ; metabolism