Primary Gastric Yolk Sac Tumour

A Rare Intersection: A Case of Gastric Adenocarcinoma With Yolk Sac Differentiation

This case report presents a rare instance of a 73-year-old male diagnosed with a yolk sac tumor (YST) coexisting with adenocarcinoma components in the stomach. YSTs are primarily gonadal and seldom occur in extragonadal sites such as the gastrointestinal tract. The patient underwent curative resection followed by chemotherapy, resulting in long-term survival without recurrence. This case contributes to the limited existing literature on gastric YSTs, emphasizing the importance of early diagnosis and effective treatment for this aggressive malignancy. It serves as a valuable addition to our understanding of the pathophysiology, diagnosis, and management of this rare condition.

Primary yolk sac tumor in the abdominal wall in a 20-year-old woman: A case report

BACKGROUND

Extragonadal yolk sac tumors (YSTs) are rare, with only a low reported tumor occurrence outside the gonads locally and abroad. Extragonadal YSTs are usually a diagnostic challenge, because they are infrequent, but also because a thoughtful and detailed differential diagnostic process must be performed.

CASE SUMMARY

Here we present a case of an abdominal wall YST in a 20-year-old woman admitted with a tumor in the lower abdomen close to the umbilicus. The tumorectomy was performed. The histological examination revealed characteristic findings such as Schiller-Duval bodies, loose reticular structures, papillary structures, and eosinophilic globules. According to the immunohistochemical staining, the tumor tissue was positive for broad-spectrum cytokeratin, Spalt-like transcription factor 4, glypican-3, CD117, and epithelial membrane antigen. Based on the clinical information, histological features, and immunohistochemical staining profile, the tumor was diagnosed as a YST present in the abdominal wall.

CONCLUSION

Based on the clinical information, histological features, and immunohistochemical staining profile described above, the tumor was diagnosed as a primary YST in the abdominal wall.

Long-term survival without recurrence after surgery for gastric yolk sac tumor-like carcinoma: a case report

Background

Gastric yolk sac tumor (YST)-like carcinoma is extremely rare, and its prognosis is poor, because most patients have widespread metastases at the time of diagnosis. We report a case of gastric YST-like carcinoma with an adenocarcinoma component without metastases in which curative resection was performed.

Case presentation

A 77-year-old man complaining of melena and dizziness due to anemia was diagnosed with poorly differentiated adenocarcinoma in the gastric cardia, with a benign ulcer in the gastric body. He underwent total gastrectomy with D2 lymph node dissection for the tumor. Histological examination of the resected specimens revealed a mixture of reticular and glandular neoplastic components morphologically. In the reticular area, an endodermal sinus pattern and some Schiller–Duval bodies were confirmed. Gastric YST-like carcinoma with adenocarcinoma components, T2N0M0 Stage IB, was diagnosed. Immunohistochemical analysis showed that the YST was positive for carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) and p53. In contrast, the adenocarcinoma was positive for p53 and negative for CEA and AFP. The patient remained healthy as of 7 years postoperatively, with no recurrence.

Conclusions

Routine medical examinations or endoscopic examinations for accidental symptom may be helpful for early diagnosis and good prognosis for gastric YST-like carcinoma, although the prognosis is generally poor.

A Case of Primary Sinonasal Yolk Sac Tumor

Yolk sac tumor (YST) is a rare and highly malignant germ cell tumor that is extremely rare in the nasal region. Herein, we present a case of biopsy-proven nasal YST admixed with transitional cell carcinoma in a 58-year-old woman. Complementary F-FDG PET/CT revealed the only FDG-avid mass in the right nasal cavity. This case indicates that YST could occur in the nasal region primarily, and F-FDG PET/CT is a useful tool to distinguish between primary and metastatic lesions.

Clinical characteristics and prognostic factors of male yolk sac tumor: a Surveillance, Epidemiology, and End Results program study

INTRODUCTION

Yolk sac tumor (YST) is a rare malignant germ cell tumor, which usually affects young males. Because of the low incidence, few studies on YST have been published. In our study, we aim to investigate the clinical characteristics, survival and risk factors of male YST patients based on the Surveillance, Epidemiology, and End Results (SEER) program.

METHODS

We identified 569 male YST patients from the SEER-18 database with additional treatment fields. Clinical characteristics, survival and prognostic factors were described in the study. Chi-square tests were applied to analyze categorical and continuous variables between different groups. Univariate and multivariate Cox proportional hazard model were performed to assess the relative impacts of risk factors on cancer-specific survival (CSS) in YST patients. Kaplan-Meier method and the log-rank test were used to analyze differences in survival that were significant.

RESULTS

The major primary sites of YST were testis (74.69%), mediastinum (15.47%), retroperitoneum (2.64%) and central nervous system (1.24%). The 3-year and 5-year CSS was 70.0%, 56.5% vs. 97.2%, 96.0% for the mediastinal and testicular YST patients, respectively (p < 0.001). Primary site of mediastinum, distant SEER Summary stage were independent factors of poor prognosis (hazard ratio (HR) = 2.010 (1.094-3.695), p = 0.025; HR = 6.501 (2.294-18.424), p < 0.001, respectively). Receiving surgery was a good prognosis factor for all patients (HR = 0.495 (0.260-0.940), p = 0.032) and for the mediastinal group (p = 0.0019). Being treated with chemotherapy indicated poor outcome in all patients (HR = 3.624 (1.050-12.507), p = 0.042) and in the localized testicular YST patients (p = 0.0077).

CONCLUSION

For the first time, our study revealed the primary site distribution of male YST, and summarized the clinical characteristics, survival and prognostic factors based on the SEER database, which provided important epidemiological evidence for clinical practice.