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1120 An unsual presentation of a gynecological tumor: extragonadal yolk sac tumor of the vulva
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  1. SA Duru Çöteli1,
  2. G Yeter2,
  3. A Usubütün2 and
  4. N Boran1
  1. 1Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Turkey
  2. 2Hacettepe Üniversitesi Tıp Fakültesi, Turkey

Abstract

Introduction/Background*Extragonadal yolk sac tumours (YST) of the external genitalia is a rare malignancy. Up to date 15 cases have been reported in the literature. YST are highly aggressive, however with the use of chemotherapy survival has improved. The disease-free survival in vulvar YSTs has been reported as 15-90 months with the use of chemotherapy. We present a case of vulvar YST that has been managed with local excision and adjuvant chemotherapy.

Methodology Case Report

Result(s)*A 34-year-old woman presented to our institution with a left vulvar mass reported as primary adenocarcinoma of the vulva. She had given birth six months ago and noticed the mass in the last four months. During the examination a left, painless, mobile mass of average 7 cm was detected on the left side of vulva, inguinal palpation was normal, and no abnormalities was detected in the internal genitalia (figure 1). In the pelvic MRI a 69*65*55 mm vulvar mass was reported, and this mass showed a FDG uptake of 11.5 SUVmax in the PET- CT. No distant and nodal uptake was detected. Also, upper, and lower gastrointestinal endoscopies were reported normal.

A vulvar mass resection and left superficial inguinal lymphadenectomy was performed. During the operation the mass was mobile and no invasion with other tissues was detected. The final pathology specimen was diagnosed as yolk sac tumour of the vulva, all surgical margins and lymph nodes were negative (figure 2). The patient was given four cycles of Bleomycin, Etoposide and Cisplatin (BEP) chemotherapy. She is being regularly examined every three months and no relapse has been detected in 10 months.

Conclusion*Primary YST of the vulva is extremely rare and this case is the 16. case in the literature. Local excision and adjuvant BEP chemotherapy should be the choice of treatment in these patients.

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