Image Description
Microscopic Features: Like its testicular counterpart, the ovarian yolk sac tumor displays a variety of architectural patterns, including (in order of decreasing frequency): microcystic/reticular (shown here), myxomatous, endodermal sinus/perivascular, solid, glandular, macrocystic, hepatoid, papillary, sarcomatoid/spindle cell, parietal, and polyvesicular vitelline pattern.
Most cases contain an admixture of two or more patterns. The individual patterns are shown and described in the next several images.
About the Disease
Germ cell tumors (GCT) of the ovary originate from primordial germ cells and make up 30% of all primary ovarian neoplasms. More than 90% of ovarian GCT are mature cystic teratomas which are benign tumors. Remaining 5% are malignant. Malignant GCT make up 3% and 20% of all ovarian cancers in Western countries and Asian/African countries respectively. Patients with malignant GCT are usually between 15-30 yrs. of age. Tumors are large (average size 16 cm) and generally unilateral (except dysgerminomas; 10-20% cases are bilateral). Presenting symptoms are abdominal enlargement and pelvic pain. Serum hCG and AFP levels can give a clue to the diagnosis and are useful in monitoring postoperatively. The treatment consists of fertility-sparing surgery followed by combination chemotherapy. About 60-75% of patients present with Stage I disease which has a cure rate of almost 100%. About 25-30% have Stage III disease at diagnosis and the cure rate is around 75%. REFERENCES: 1. WHO Classification of Tumors. Female Genital Tumors. 5th Edition, 2020; IARC, Lyon, France. 2. Nucci MR, Parra-Herran C (2021). Gynecologic Pathology. 2nd Edition. Philadelphia, PA. Elsevier. 3. Goldblum, J. R. et al (2018). Rosai and Ackerman's Surgical Pathology - Eleventh Edition. Philadelphia, PA. Elsevier.