Prognostic significance of histopathological subtypes in stage I pure yolk sac tumour of the ovary

Sasaki, Hiroshi; Furusato, Masakuni; Teshima, Shin‐ichi; Kiyokawa, Takako; Tada, Akio; Aizawa, Shigeo; Yamabe, T; Tsugane, Shoichiro; Terashima, Y.

doi:10.1038/bjc.1994.96

Cited by 20 publications

(2 citation statements)

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“…There have been surprisingly few studies of the microscopic features of YST of the ovary [19][20][21][22][23][24][25][26][27][28] partly because of its rarity; in the ~50 year experience at a large children's hospital only 14 cases were seen. 29 The number of cases in many studies is small, exceeding 20 in only 4.…”

Section: Introductionmentioning

confidence: 99%

Yolk Sac Tumor of the Ovary

Young

Stall²

2021

American Journal of Surgical Pathology

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One hundred fifty yolk sac tumors (YSTs) of the ovary in patients from 1 to 61 (mean: 21.5) years of age are described; 75% of the patients were in the second and third decades and only 1 was above 50 years of age. The clinical manifestations were typically related to a fast-growing adnexal mass; endocrine manifestations (hirsutism) were present in only 2 cases. The tumors were all unilateral and 70% were ≥15 cm; an associated dermoid cyst was present in 20 cases. The tumors were solid and cystic in 57% of the cases, 25% were multicystic, and 18% uniformly solid. The solid tissue was typically tan to pink or yellow and often friable with hemorrhage and necrosis; smaller solid neoplasms were sometime uniformly yellow. The most common histologic pattern was reticular composed of an irregular meshwork of spaces that was conspicuous in 68% of the neoplasms but present to at least a minor degree in all of them. That appearance almost always merged with small to large cysts that were prominent in about 40% of tumors. In 25% of the tumors, cysts sometimes associated with a cellular stroma (the polyvesicular pattern), were present but conspicuous in only half these cases. One third of the tumors had a labyrinthine pattern, 22% glands, and 6% a festoon pattern. Papillae with a central blood vessel (Schiller-Duval bodies) were seen in one-third of the tumors but were numerous in only 5% of them. Nonspecific appearing papillae were seen in 10% of the tumors. A solid growth of cells with pale cytoplasm was seen in one-third of the tumors but was conspicuous in only half of that subset. The solid appearance was typically reminiscent of that of dysgerminoma, but lacked the septa and lymphocytic infiltrate of that neoplasm. Nine tumors had a component of cells with scant cytoplasm resulting in a blastema-like appearance and 3 had cells with abundant clear cytoplasm. Cords and clusters of cells were common but did not dominate the microscopic appearance. The stroma typically had a nonspecific collagenous to edematous appearance. Stromal luteinization was seen in 12 tumors; in 5 this was likely due to the patient being pregnant. Two tumors had minor foci of cells that resembled hepatocytes. Hyaline bodies were seen in most of the tumors and were often conspicuous. The neoplastic cells typically had modest amounts of lightly staining cytoplasm and only mild nuclear pleomorphism. Cells lining cysts were often flattened sometimes resulting in a deceptively innocuous appearance. Many of the tumors (mostly consultation cases), caused diagnostic difficulty; tumors in the differential diagnosis included clear cell carcinoma, embryonal carcinoma, Sertoli-Leydig cell tumor, and juvenile granulosa cell tumor. The patient age and marked elevation of the serum alpha-fetoprotein level (if measured) is helpful in many of these considerations. The overtly malignant gross appearance of most YSTs contrasts with certain other tumors in the differential and the association of some YSTs with dermoid cyst and many clear cell carcinomas with endometri...

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Section: Introductionmentioning

confidence: 99%

Yolk Sac Tumor of the Ovary

Young

Stall²

2021

American Journal of Surgical Pathology

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“…En revanche, les caractéristiques histologiques sembleraient pouvoir différencier certaines TSVO à moins bon pronostic. Ainsi, pour les stades I, la combinaison de trois ou quatre variants semble avoir un meilleur pronostic que lorsqu'il n'est retrouvé qu'un ou deux variants [37]. Au plan thérapeutique, le fait que le traitement chirurgical soit conservateur ne semble pas affecter le pronostic dans les séries étudiant les TGOM [38][39][40][41][42], ni dans les séries étudiant spécifiquement les TSVO [32,34,35].…”

Section: Facteurs Pronostiquesunclassified

Tumeurs du sac vitellin de l’ovaire : revue de la littérature

et al. 2011

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Nonepithelial Ovarian Malignancies

Berek

Friedlander

Bast

2017

Holland‐Frei Cancer Medicine

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Overview Compared with epithelial ovarian cancers, nonepithelial ovarian tumors are uncommon, constituting <10% of all ovarian malignancies. They include germ cell malignancies, sex‐cord–stromal tumors, carcinomas metastatic to the ovary, and a variety of extremely rare ovarian cancers, including sarcomas and lipoid cell tumors. Although there are many similarities in the presentation, evaluation, and management of patients, these tumors also have unique features that require special approaches to management. Germ cell malignancies are derived from primordial germ cells of the ovary and can be distinguished by histotype and expression of the biomarkers alpha‐fetoprotein (AFP) and/or human chorionic gonadotropin (hCG). They include dysgerminomas (AFP−hCG−), embryonal carcinomas (AFP+hCG+), immature teratomas (AFP−hCG−), endodermal sinus (yolk sac) tumors (AFP+hCG−), and ovarian choriocarcinomas (AFP−hCG+). Germ cell tumors occur in premenarchal girls and young women, grow rapidly, and can present with a symptomatic pelvic mass. As preservation of fertility is often an important priority, unilateral salpingo‐oophorectomy can often be performed followed by adjuvant platinum‐based therapy. Among the germ cell tumors, dysgerminomas can be bilateral in 10–15% of cases and are associated with gonadal dysgenesis in 5% of cases. Metastatic germ cell cancers can be quite sensitive to chemotherapy and the long‐term survival rate is high, even in advanced stages. At some institutions, young patients with stage IA germ cell tumors are followed carefully after resection and chemotherapy given only if there is recurrence with excellent outcomes. Sex‐Cord‐Stromal tumors include Granulosa‐Stromal tumors, Juvenile Granulosa tumors, and Sertoli–Leydig cell tumors. Granulosa‐Stromal tumors can occur at all ages and produce estrogen resulting in pseudoprecocious puberty in a small fraction of girls, amenorrhea in pre‐menopausal women, and endometrial hyperplasia in postmenopausal adults. Granulosa‐Stromal tumors are indolent and often confined to one ovary where surgery can cure stage I disease in more than 75% of cases. Adjuvant chemotherapy is generally not given after complete resection. Late recurrence has, however, been observed. Persistent or recurrent disease has responded to platinum based and hormonal therapy, including progestational agents, luteinizing hormone‐releasing hormone agonists, and aromatase inhibitors. Inhibin B has been a useful biomarker. Sertoli–Leydig cell tumors generally present in the third or fourth decade, produce androgens, and induce virilization in more than 70% of patients. As many Sertoli–Leydig cell tumors are in early stage and rarely bilateral, unilateral salpingo‐oophorectomy is often performed with 70–90% 5‐year survival.

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Prognostic significance of histopathological subtypes in stage I pure yolk sac tumour of the ovary

Cited by 20 publications

References 24 publications

Yolk Sac Tumor of the Ovary

Yolk Sac Tumor of the Ovary

Tumeurs du sac vitellin de l’ovaire : revue de la littérature

Nonepithelial Ovarian Malignancies

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