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Unusual Patterns, Subtypes, and Differential Diagnosis of Gonadal Yolk Sac Tumors

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The Human Yolk Sac and Yolk Sac Tumors

Abstract

Teilum first elucidated the nature of yolk sac tumors (YSTs) (Teilum 1959) and delineated their most common patterns (Teilum 1976): (1) loose vacuolated (reticular), (2) endodermal sinus (containing Schiller-Duval bodies), (3) honeycomb, (4) labyrinthine, (5) cystic, (6) polyvesicular vitelline, (7) myxoid, and (8) compact. Teilum mentioned only briefly two recently emphasized patterns of YST, the parietal and mesenchyme-like, which are presented in the first part of this review. The second part of the review considers two other patterns that may be seen in YSTs, the glandular and hepatoid, which are sufficiently distinctive as to be classified as specific subtypes of YST in the classification of YSTs currently being formulated by the World Health Organization, a slightly modified version of which is presented in Table 17.1. A third section briefly considers yolk sac elements in mixed germ cell tumors. In the final section the differential diagnosis of all types of YST of the ovary and testis is discussed.

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References

  • Cardoso de Almeida PC, Scully RE (1983) Diffuse embryoma of the testis. A distinctive form of mixed germ cell tumor. Am J Surg Pathol 7:633–642.

    Article  PubMed  CAS  Google Scholar 

  • Clement PB, Young RH, Scully RE (1987) Endometrioid-like variant of ovarian yolk sac tumor. A clinicopathological analysis of eight cases. Am J Surg Pathol 11:767–778.

    Article  PubMed  CAS  Google Scholar 

  • Cohen MB, Mulchahey KM, Molnar JJ (1986) Ovarian endodermal sinus tumor with intestinal differentiation. Cancer 57:1580–1583.

    Article  PubMed  CAS  Google Scholar 

  • Cohen MB, Friend DS, Molnar JJ, Talerman A (1987) Gonadal endodermal sinus tumor (yolk sac) with pure intestinal differentiation: a new histologic type. Pathol Res Pract 182:609–616.

    Article  PubMed  CAS  Google Scholar 

  • Damjanov I, Amenta PS, Zarghami F (1984) Transformation of an AFP-positive yolk sac carcinoma into an AFP-negative neoplasm. Evidence for in vivo cloning of the human parietal yolk sac carcinoma. Cancer 53:1902–1907.

    Article  PubMed  CAS  Google Scholar 

  • Gagnon S, Tetu B, Silva EG, McCaughey WTE (1989) Frequency of α-fetoprotein production by Sertoli-Leydig cell tumors of the ovary: an immunohistochemical study of eight cases. Mod Pathol 2:63–67.

    PubMed  CAS  Google Scholar 

  • Hayes MC, Scully RE (1987) Ovarian steroid cell tumors, not otherwise specified (lipid cell tumors): a clinicopathological analysis of 63 cases. Am J Surg Pathol 11:835–845.

    Article  PubMed  CAS  Google Scholar 

  • Huntington RW, Morgenstern NL, Sargent JA, Giern RN, Richards A, Hanford KL (1963) Germinal tumors exhibiting the endodermal sinus pattern of Teilum in young children. Cancer 16:34–47.

    Article  PubMed  Google Scholar 

  • Ishikura H, Scully RE (1987) Hepatoid carcinoma of the ovary. A newly described tumor. Cancer 60:2775–2784.

    Article  PubMed  CAS  Google Scholar 

  • Jacobsen GK, Jacobsen M (1983) Possible liver cell differentiation in testicular germ cell tumours. Histopathology 7:537–548.

    Article  PubMed  CAS  Google Scholar 

  • Jacobsen GK, Talerman A (1989) Atlas of germ cell tumors. Munksgaard, Copenhagen, p 73.

    Google Scholar 

  • Kazancigil TR, Laqueur W, Ladewig P (1940) Papillo-endothelioma ovarii. Report of three cases and a discussion of Schiller’s “mesonephroma ovarii”. Am J Cancer 40:199–212.

    Google Scholar 

  • Kim CR, Hsiu J-G, Given FT (1989) Intestinal variant of ovarian endodermal sinus tumor. Gynecol Oncol 33:379–381.

    Article  PubMed  CAS  Google Scholar 

  • Klemi PJ, Meurman L, Gronroos M, Talerman A (1982) Clear cell (mesonephroid) tumors of the ovary with characteristics resembling endodermal sinus tumor. Int J Gynecol Pathol 1:95–100.

    Article  PubMed  CAS  Google Scholar 

  • Kurman RJ, Norris NJ (1976a) Embryonal carcinoma of the ovary. A clinicopathologic entity distinct from endodermal sinus tumor resembling embryonal carcinoma of the adult testis. Cancer 38:2420–2433.

    Article  PubMed  CAS  Google Scholar 

  • Kurman RJ, Norris HJ (1976b) Endodermal sinus tumor of the ovary. A clinical and pathologic analysis of 71 cases. Cancer 38:2404–2419.

    Article  PubMed  CAS  Google Scholar 

  • Langley FA, Govan ADT, Anderson MC, Gowing NFC, Woodcock AS, Harilal KR (1981) Yolk sac and allied tumors of the ovary. Histopathology 5:389–401.

    Article  PubMed  CAS  Google Scholar 

  • Lawrence WD, Young RH, Scully RE (1985) Juvenile granulosa cell tumor of the infantile testis: a report of fourteen cases. Am J Surg Pathol 9:87–94.

    Article  PubMed  CAS  Google Scholar 

  • Michael H, Ulbright TM, Brodhecker CA (1989) The pluripotential nature of the mesenchyme-like component of yolk sac tumor. Arch Pathol Lab Med 113:1115–1119.

    PubMed  CAS  Google Scholar 

  • Nakashima N, Fukatsu T, Nagasaka T, Sobue M, Takeuchi J (1987) The frequency and histology of hepatic tissue in germ cell tumors. Am J Surg Pathol 11:682–692.

    Article  PubMed  CAS  Google Scholar 

  • Nogales FF, Matilla A, Nogales-Ortiz F, Galera-Davidson HL (1978) Yolk sac tumors with pure and mixed polyvesicular vitelline patterns. Hum Pathol 9:553–566.

    Article  PubMed  Google Scholar 

  • Nogales FF, Ayala A, Ruiz-Avila I, Sirvent JJ (1991) Myxoid leiomyosarcoma of the ovary. Analysis of 3 cases. Hum Pathol 22:1268–1273.

    Article  PubMed  CAS  Google Scholar 

  • Perrone T, Steeper TA, Dehner LP (1987) Alpha-fetoprotein localization in pure ovarian teratoma. An immunohistochemical study of 12 cases. Am J Clin Pathol 88:713–717.

    PubMed  CAS  Google Scholar 

  • Prat J, Bhan AK, Dickersin GR, Robboy SJ, Scully RE (1982) Hepatoid yolk sac tumor of the ovary (endodermal sinus tumor with hepatoid differentiation). A light microscopic ultrastructural and immunohistochemical study of seven cases. Cancer 50:2355–2368.

    Article  PubMed  CAS  Google Scholar 

  • Prat J, Matias-Guiu X, Scully RE (1989) Hepatic yolk sac differentiation in an ovarian polyembryoma. Surg Pathol 2:147–150.

    Google Scholar 

  • Rutgers JL, Young RH, Scully RE (1987) Ovarian yolk sac tumor arising from an endometrioid carcinoma. Hum Pathol 18:1296–1299.

    Article  PubMed  CAS  Google Scholar 

  • Salazar H, Kanbour A, Tobon H, Gonzalez-Angulo A (1974) Endodermal cell derivatives in embryonal carcinoma of ovary: an electron microscopy study of two cases (abstract). Am J Pathol 74:108a.

    Google Scholar 

  • Schiller W (1939) Mesonephroma ovarii. Am J Cancer 35:1–21.

    Google Scholar 

  • Stewart KR, Casey MJ, Gondos B (1981) Endodermal sinus tumor of the ovary with virilization. Light-and electron-microscopic study. Am J Surg Pathol 5:385–391.

    Article  PubMed  CAS  Google Scholar 

  • Teilum G (1959) Endodermal sinus tumors of the ovary and testis. Comparative morphogenesis of the so-called mesonephroma ovarii (Schiller) and extraembryonic (yolk sac-allantoic) structures of the rat’s placenta. Cancer 12:1092–1104.

    Article  PubMed  CAS  Google Scholar 

  • Teilum G (1965) Classification of endodermal sinus tumor (mesoblastoma vitellinum) and so-called “embryonal carcinoma” of the ovary. Acta Pathol Microbiol Scand 64:407–429.

    PubMed  CAS  Google Scholar 

  • Teilum G (1976) Special tumors of ovary and testis and related extragonadal lesions. Comparative pathology and histological identification, 2nd edn. Munksgaard, Copenhagen, pp 44–47.

    Google Scholar 

  • Ulbright TM, Roth LM, Brodhecker CA (1986) Yolk sac differentiation in germ cell tumors. A morphologic study of 50 cases with emphasis on hepatic, enteric, and parietal yolk sac features. Am J Surg Pathol 10:151–164.

    Article  PubMed  CAS  Google Scholar 

  • Young RH, Scully RE (1983) Ovarian Sertoli-Leydig cell tumors with a retiform pattern: a problem in histopathologic diagnosis. A report of 25 cases. Am J Surg Pathol 7:755–771.

    Article  PubMed  CAS  Google Scholar 

  • Young RH, Scully RE (1985) Ovarian Sertoli-Leydig cell tumors. A clinicopathological analysis of 207 cases. Am J Surg Pathol 9:543–569.

    Article  PubMed  CAS  Google Scholar 

  • Young RH, Scully RE (1987) Oxyphilic clear cell carcinoma of the ovary. A report of nine cases. Am J Surg Pathol 11:661–667.

    Article  PubMed  CAS  Google Scholar 

  • Young RH, Dickersin GR, Scully RE (1984a) Juvenile granulosa cell tumor of the ovary. A clinicopathological analysis of 125 cases. Am J Surg Pathol 8:575–596.

    Article  PubMed  CAS  Google Scholar 

  • Young RH, Dudley AG, Scully RE (1984b) Granulosa cell, Sertoli-Leydig cell, and unclassified sex cord-stromal tumors associated with pregnancy: a clinicopathological analysis of thirty-six cases. Gynecol Oncol 18:181–205.

    Article  PubMed  CAS  Google Scholar 

  • Young RH, Perez-Atayde AR, Scully RE (1984c) Ovarian Sertoli-Leydig cell tumor with retiform and heterologous components. Report of a case with hepatocytic differentiation and elevated serum alpha-fetoprotein. Am J Surg Pathol 8:709–718.

    Article  PubMed  CAS  Google Scholar 

  • Young RH, Scully RE (1991) Malignant melanoma metastatic to the ovary. A clinicopathologic study of 20 cases. Am J Surg Pathol 15:849–866.

    Article  PubMed  CAS  Google Scholar 

  • Young RH, Silva EG, Scully RE (1991b) Ovarian and juxtaovarian adenomatoid tumors. A report of six cases. Int J Gynecol Pathol 10:364–371.

    Article  PubMed  CAS  Google Scholar 

  • Young RH, Gersell DJ, Clement PB, Scully RE (1992) Hepatocellular carcinoma metastatic to the ovary. A report of three cases discovered during life with discussion of the differential diagnosis of hepatoid tumors of the ovary. Hum Pathol 23:574–580.

    Article  PubMed  CAS  Google Scholar 

  • Zirker T, Silva E, Morris M, Ordonez N (1989) Immunohistochemical differentiation of clear cell carcinoma of the female genital tract and endodermal sinus tumor with the use of alpha-fetoprotein and LEU-M1. Am J Clin Pathol 91:511–514.

    PubMed  CAS  Google Scholar 

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© 1993 Springer-Verlag Berlin Heidelberg

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Young, R.H., Scully, R.E. (1993). Unusual Patterns, Subtypes, and Differential Diagnosis of Gonadal Yolk Sac Tumors. In: Nogales, F.F. (eds) The Human Yolk Sac and Yolk Sac Tumors. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77852-0_17

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  • DOI: https://doi.org/10.1007/978-3-642-77852-0_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-77854-4

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