Yolk Sac Tumor

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Lin Xue - One of the best experts on this subject based on the ideXlab platform.

  • prognosis of eight chinese cases of primary vaginal Yolk Sac Tumor with a review of the literature
    Asian Pacific Journal of Cancer Prevention, 2014
    Co-Authors: Qionglan Tang, Xuefeng Jiang, Xiaoping Yuan, Yong Liu, Lin Zhang, Xiaofeng Tang, Jiajia Zhou, Jianpei Fang, Lin Xue
    Abstract:

    Background: Primary vaginal Yolk Sac Tumor is a rare malignancy in the pediatric population, and a diagnostic challenge and appropriate initial treatment remains unsolved. The aim of this study was to investigate the clinicopathologic features, treatment and prognosis of this Tumor. Materials and Methods: Eight cases of primary vaginal Yolk Sac Tumor were reported with a literature review. Results: There were 4 pure Yolk Sac Tumor cases and four mixed germ cell Tumors containing Yolk Sac Tumor element, including two cases with embryonal carcinoma and two cases with embryonal carcinoma and dysgerminoma. Partial vaginectomy was performed in four cases and all patients received chemotherapy. 85 cases in literatures were reviewed and 9 cases were misdiagnosed. Follow-up data was available in 77 cases and 5-year overall survival rate was 87.6%. 5-year survival rate of biopsy with chemotherapy, conservative surgery with chemotherapy and radical surgery with chemotherapy was 91.1%, 100% and 28.6%, respectively (p<0.001). Compared to cases without relapse or metastasis after initial treatment, patients with relapse or metastasis had a shorter overall survival (35.6% vs 96.6%, p<0.001). Conclusions: Mixed germ cell Tumor containing Yolk Sac Tumor element was not uncommon and partial vaginectomy may be a good choice for primary vaginal mixed Yolk Sac Tumor type to eradicate local Tumor cells and provide complete information for pathological diagnosis and postoperative adjuvant therapy.

Andrew J Kirsch - One of the best experts on this subject based on the ideXlab platform.

  • a rare case of pediatric vaginal Yolk Sac Tumor
    Urology, 2018
    Co-Authors: Michelle A Lightfoot, Aylin N Bilgutay, Andrew J Kirsch
    Abstract:

    A 14-month-old girl was evaluated for intermittent vaginal bleeding. Vaginoscopy revealed a friable Tumor, and biopsy results confirmed a Yolk Sac Tumor. Alpha-fetoprotein was elevated (1386 ng/mL) at diagnosis but quickly normalized with chemotherapy. The patient remained Tumor-free 12 months after diagnosis without the need for radical surgery. Although rare, malignant Tumors of the vagina must be included in the differential diagnosis of prepubertal girls who present with vaginal bleeding. Primary Yolk Sac Tumor of the vagina is seen in girls less than 3 years of age and is treated with chemotherapy with or without surgical excision. Prognosis is good with appropriate treatment.

Lin Zhang - One of the best experts on this subject based on the ideXlab platform.

  • multidisciplinary team for the diagnosis and treatment of 2 cases of primary intestinal Yolk Sac Tumor
    Cancer biology and medicine, 2018
    Co-Authors: Qiujuan Huang, Lin Zhang, Changxu Liu, Ruijun Tang, Lei Zhu, Yuhong Guo, Lingyi Yang, Yalei Wang, Baocun Sun, Bin Meng
    Abstract:

    Extragonadal primary Yolk Sac Tumor of the intestinal tract origin is exceedingly rare. Through a multiple disciplinary team, the diagnosis and treatment of primary intestinal Yolk Sac Tumor were further defined. We report 2 such cases with detailed histologic and immunohistochemical analysis. The two patients were a 7-year-old girl and a 29-year-old woman. Both of them preoperatively had an elevated serum alpha fetoprotein (AFP) level (≥ 1,210 ng/mL). The Tumors are located in the intestine and imaging examination indicated the rectum as the primary site. Grossly the mass was grey-white and crisp texture. Microscopic examination featured reticular, microcystic, macrocystic, papillary, solid, and some glandular patterns. Immunohistochemically, Tumor cells of both cases were positive for SALL4, AFP, pan-cytokeratin (AE1/AE3), and glypican-3. Simultaneously, a stain for EMA, OCT4, CD30, HCG, vimentin and CK20 were negative in all 2 neoplasms. The features of morphology, immunohistochemistry, laboratory examinations and imaging studies consist of the diagnosis of primary Yolk Sac Tumor of the intestine.

  • prognosis of eight chinese cases of primary vaginal Yolk Sac Tumor with a review of the literature
    Asian Pacific Journal of Cancer Prevention, 2014
    Co-Authors: Qionglan Tang, Xuefeng Jiang, Xiaoping Yuan, Yong Liu, Lin Zhang, Xiaofeng Tang, Jiajia Zhou, Jianpei Fang, Lin Xue
    Abstract:

    Background: Primary vaginal Yolk Sac Tumor is a rare malignancy in the pediatric population, and a diagnostic challenge and appropriate initial treatment remains unsolved. The aim of this study was to investigate the clinicopathologic features, treatment and prognosis of this Tumor. Materials and Methods: Eight cases of primary vaginal Yolk Sac Tumor were reported with a literature review. Results: There were 4 pure Yolk Sac Tumor cases and four mixed germ cell Tumors containing Yolk Sac Tumor element, including two cases with embryonal carcinoma and two cases with embryonal carcinoma and dysgerminoma. Partial vaginectomy was performed in four cases and all patients received chemotherapy. 85 cases in literatures were reviewed and 9 cases were misdiagnosed. Follow-up data was available in 77 cases and 5-year overall survival rate was 87.6%. 5-year survival rate of biopsy with chemotherapy, conservative surgery with chemotherapy and radical surgery with chemotherapy was 91.1%, 100% and 28.6%, respectively (p<0.001). Compared to cases without relapse or metastasis after initial treatment, patients with relapse or metastasis had a shorter overall survival (35.6% vs 96.6%, p<0.001). Conclusions: Mixed germ cell Tumor containing Yolk Sac Tumor element was not uncommon and partial vaginectomy may be a good choice for primary vaginal mixed Yolk Sac Tumor type to eradicate local Tumor cells and provide complete information for pathological diagnosis and postoperative adjuvant therapy.

Thomas M. Ulbright - One of the best experts on this subject based on the ideXlab platform.

  • Gonadoblastoma and hepatoid and endometrioid-like Yolk Sac Tumor: an update.
    International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists, 2014
    Co-Authors: Thomas M. Ulbright
    Abstract:

    Dr Robert E. Scully greatly advanced our understanding of germ cell neoplasia to the extent that it is difficult to narrow the discussion of his contributions to this topic so that it can be covered in a brief article. This article accordingly focuses on some of the recent developments concerning 2 of his major contributions in this area-the gonadoblastoma (GB) and variant morphologies of Yolk Sac Tumor. GB was defined by Dr Scully in 1953 and its features elaborated in detail by him in 1970. This neoplasm occurred in young patients who often displayed phenotypic sex ambiguities and frequently presented with primary amenorrhea. It was bilateral in 40%, and consisted of circumscribed nests of small sex cord cells and germinoma-like cells admixed with round deposits of eosinophilic, hyaline, often calcified material. These nests were set in a spindle cell gonadal stroma with Leydig-like or lutein-like cells. Because of his work we now understand that this precursor to invasive germ cell Tumors occurs in patients with a specific form of disorder of sex development, namely gonadal dysgenesis, and only in those who have a particular portion of the Y chromosome, the GB locus/TSPY gene, within the gonadal tissue. An essential element to the development of GB appears to be a defect in the genetic pathway that leads to the development of Sertoli cells. Improperly formed Sertoli cells predispose to "delayed maturation" of the gonocytes of the gonad and predispose them to undergo malignant transformation. "Undifferentiated gonadal tissue" has been proposed as the precursor to the development of GB and consists of an unorganized mixture of apparently non-neoplastic germ cells, germ cells with delayed maturation, and neoplastic germ cells with sex cord cells and gonadal stroma. Two variant morphologies of Yolk Sac Tumor were also recognized by Dr Scully. In the hepatoid variant features similar to hepatocellular carcinoma occurred, although primitive glandular foci and lack of liver involvement permitted its distinction in most cases. More recently this variant has been found to occasionally produce bile in canalicular-like structures and to stain strongly for both SALL4 and glypican 3, 2 recently described markers of Yolk Sac Tumor. Recognition of hepatoid Yolk Sac Tumor was followed by the description of a potential mimic, primary ovarian hepatoid carcinoma, which, however, occurred in a significantly older patient population and was occasionally associated with surface epithelial neoplasia. The endometrioid-like variant of Yolk Sac Tumor simulated primary endometrioid adenocarcinoma. It can be suspected on routine stains because of primitive appearing nuclei, frequent subnuclear vacuoles, and in some cases association with more usual Yolk Sac Tumor. Its recognition is now facilitated by a panel of immunohistochemical stains that are often expressed differentially in these 2 neoplasms--endometrioid-like Yolk Sac Tumor: positive for SALL4, glypican 3, and α-fetoprotein; endometrioid adenocarcinoma: positive for cytokeratin 7 and epithelial membrane antigen. Finally, Dr Scully contributed one of the first cases in the literature of yet another nuance in the complicated world of Yolk Sac neoplasia, namely the development of some Tumors on the background of a surface epithelial neoplasm. This is analogous to the more common development of choriocarcinoma from carcinoma and, in the case of Yolk Sac Tumor, diagnosis is aided clinically by the usual older age of the patient and nature of the associated neoplasia.

  • Solid pattern Yolk Sac Tumor: a morphologic and immunohistochemical study of 52 cases.
    The American journal of surgical pathology, 2012
    Co-Authors: Chia Sui Kao, Muhammad T. Idrees, Robert H. Young, Thomas M. Ulbright
    Abstract:

    Yolk Sac Tumors may exhibit numerous patterns. One that has received little attention overall, yet is not uncommon, is a solid pattern, which is especially prone to misinterpretation, usually as seminoma, in biopsy specimens from metastatic or mediastinal sites. This distinction is of critical importance as the 2 Tumors are treated differently. To determine features useful in the diagnosis of solid Yolk Sac Tumor we reviewed 52 germ cell Tumors (28 testicular primaries, 21 metastases from the testis, and 3 mediastinal primaries) that had a Yolk Sac Tumor component with foci of solid growth, defined as a sheet-like arrangement of Tumor cells occupying >2 mm and with no or only rare microcysts. Solid Yolk Sac Tumor was almost always associated with other patterns, most commonly microcystic/reticular (75%), glandular (35%), and myxoid (25%). The solid foci consisted of sheets of cells with usually abundant cytoplasm that was mostly (85%) pale to clear and frequently had intercellular basement membrane deposits (75%), rare microcysts (67%), significant nuclear pleomorphism (65%), and hyaline globules (65%). In 2 cases (4%), the cells were small with scant cytoplasm (blastema-like variant). A myxoid background (39%), lymphocytic infiltrate (17%), and an applique pattern (8%) were sometimes observed. On immunostaining, AE1/AE3 cytokeratin and glypican 3 provided the most intense and diffuse reactivity for solid Yolk Sac Tumor, whereas α-fetoprotein was negative in 38%. CD117 stained 59%, whereas only rare cells in 1 case (3%) were weakly reactive for podoplanin; OCT3/4 was uniformly negative. We conclude that solid Yolk Sac Tumor can generally be recognized by careful morphologic evaluation, especially its association with other Yolk Sac Tumor patterns, the presence of intercellular band-like deposits of basement membrane, occasional microcysts, nuclear pleomorphism, intracellular hyaline globules, and usual absence of lymphocytes. In difficult cases a concise immunohistochemical panel consisting of AE1/AE3, glypican 3, and OCT3/4 distinguishes solid Yolk Sac Tumor from other neoplasms. α-fetoprotein stains are commonly negative or weak and focal in solid Yolk Sac Tumor and cannot be solely relied on for diagnosis. Common CD117 positivity in solid pattern Yolk Sac Tumors makes it an unreliable discriminator between Yolk Sac Tumor and seminoma.

  • Evidence for the transformation of seminoma to Yolk Sac Tumor, with histogenetic considerations.
    American journal of clinical pathology, 1992
    Co-Authors: Joseph T. Czaja, Thomas M. Ulbright
    Abstract:

    Recent ultrastructural, cytogenetic, and ploidy analyses indicate that seminoma acts as a precursor from which other forms of testicular germ cell Tumor may originate. Ten cases of primary or metastatic testicular germ cell Tumors were investigated that showed possible transformation of seminoma to Yolk Sac Tumor. Such transformation was identified in six cases in which foci of abrupt change from seminoma to various patterns of Yolk Sac Tumor occurred, often at the periphery of otherwise pure lobules of seminoma. Immunostains for cytokeratins, placental-like alkaline phosphatase, and alpha-fetoprotein demonstrated the expected changes in reactivity at the foci of such transformation. Four additional cases were regarded as either seminomas with artifactual microcystic change or the close association of seminoma and Yolk Sac Tumor but lacking evidence for transformation. These data support the theory that seminoma is not an "endpoint" neoplasm but may serve a precursor role in the progression to nonseminomatous germ cell Tumors.

Qionglan Tang - One of the best experts on this subject based on the ideXlab platform.

  • prognosis of eight chinese cases of primary vaginal Yolk Sac Tumor with a review of the literature
    Asian Pacific Journal of Cancer Prevention, 2014
    Co-Authors: Qionglan Tang, Xuefeng Jiang, Xiaoping Yuan, Yong Liu, Lin Zhang, Xiaofeng Tang, Jiajia Zhou, Jianpei Fang, Lin Xue
    Abstract:

    Background: Primary vaginal Yolk Sac Tumor is a rare malignancy in the pediatric population, and a diagnostic challenge and appropriate initial treatment remains unsolved. The aim of this study was to investigate the clinicopathologic features, treatment and prognosis of this Tumor. Materials and Methods: Eight cases of primary vaginal Yolk Sac Tumor were reported with a literature review. Results: There were 4 pure Yolk Sac Tumor cases and four mixed germ cell Tumors containing Yolk Sac Tumor element, including two cases with embryonal carcinoma and two cases with embryonal carcinoma and dysgerminoma. Partial vaginectomy was performed in four cases and all patients received chemotherapy. 85 cases in literatures were reviewed and 9 cases were misdiagnosed. Follow-up data was available in 77 cases and 5-year overall survival rate was 87.6%. 5-year survival rate of biopsy with chemotherapy, conservative surgery with chemotherapy and radical surgery with chemotherapy was 91.1%, 100% and 28.6%, respectively (p<0.001). Compared to cases without relapse or metastasis after initial treatment, patients with relapse or metastasis had a shorter overall survival (35.6% vs 96.6%, p<0.001). Conclusions: Mixed germ cell Tumor containing Yolk Sac Tumor element was not uncommon and partial vaginectomy may be a good choice for primary vaginal mixed Yolk Sac Tumor type to eradicate local Tumor cells and provide complete information for pathological diagnosis and postoperative adjuvant therapy.