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1120 Yolk sac tumour in a prepubertal girl: a case report
  1. Anamika Das,
  2. Taru Gupta and
  3. Bhanvi Pandey
  1. ESIPGIMSR, Basaidarapur, New Delhi, India

Abstract

Introduction/Background Yolk Sac Tumors (YST) are the third most frequent malignant germ cell tumors of the ovary. While most of these tumours occur at a median age of 16 to 18 years, only one-third of them are premenarcheal, which makes it rarer in this age group. Abdominopelvic pain is the most frequent initial symptom, occurring in about 75% of patients, whereas an asymptomatic pelvic mass is documented in 10% of patients. Surgery followed by chemotherapy remains the mainstay of treatment.

Methodology We present the case report of 10 year old girl presented with a 15cm solid mass, palpable upto the umbilicus with restricted mobility and regular borders, associated with lower abdominal pain and significant weight loss. AFP was 30000. MRI Pelvis suggested large, well marginated, pelvico-abdominal complex solid cystic mass arising from left adnexa (8.7*12.3*15.6cm), with left hydroureter and no peritoneal or omental deposits. Based on tumour markers and radiology, a provisional diagnosis ofGerm Cell Tumour was made. On Surgical Staging, a ~12*15 cm left ovarian solid well encapsulated cyst was seen with prominent vessels and evidence of rupture classifying it into FIGO Stage 1C2. Left salpingo-oophorectomy and infracolic omentectomy was done. Peritoneal, bilateral paracolic biopsies were taken. Right tubes and ovaries were found to be normal and the uterus was infantile.

Results Histopathology confirmed the diagnosis of Yolk Sac Tumour. Peritoneal and omental biopsies were negative. Patient received 3 cycles of chemotherapy (BEP) and is still in remission with normal AFP.

Conclusion YSTs are rare accounting for less than 1% of malignant ovarian germ cell tumours, mostly in young women making fertility preservation imperative. In comparison with epithelial ovarian tumors, they are highly malignant, growing rapidly and metastasizeing fast intruding all intra-abdominal structures, but they are highly curable with BEP chemotherapy dramatically increasing survival rates to 90%. Although rare in children, physicians should be aware as it can be fatal but prompt treatment has high cure rates.

Disclosures None.

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