Ovarian yolk sac tumor

Female school

ager with abdominal distension. AXR (above left) shows displacement of the bowel loops to the left upper quadrant. Sagittal US of the abdomen (above right) shows a large solid heterogenous intraperitoneal mass in the lower right abdomen whose organ of origin was uncertain. There was a large amount of ascites. Coronal (below left) and sagittal (below right) T1 MRI with contrast of the abdomen shows a large right-sided mass that was oval in shape with smooth contour with multiple cystic lobulations with enhancing septae within it superiorly with it being more solid inferiorly and which appeared to be adherent to the right ovary.The diagnosis was ovarian endodermal sinus tumor.

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Ovarian yolk

sac tumor • Ovarian yolk sac tumor - Ganzer Fall bei Radiopaedia

Muniraj S, Ovarian yolk sac tumor. Case study, Radiopaedia.org (Accessed on 13 Dec 2023) https://doi.org/10.53347/rID-49238 • CC by-nc-sa 3.0 (modified)

Ovarian yolk

sac tumor • Ovarian yolk sac tumor - Ganzer Fall bei Radiopaedia

Baba Y, Ovarian yolk sac tumor. Case study, Radiopaedia.org (Accessed on 13 Dec 2023) https://doi.org/10.53347/rID-154879 • CC by-nc-sa 3.0 (modified)

Radiopaedia • CC-by-nc-sa 3.0 • de

Ovarian yolk sac tumors, also known as endodermal sinus tumors, are a type of ovarian germ cell tumors.

Epidemiology

Ovarian yolk sac tumor is a rare malignant ovarian germ cell tumor that usually occurs around the second decade of life. It is considered the most common malignant germ cell tumor of the ovary in children . The overall occurrence is rare, however.

Pathology

They are typically well-encapsulated round to oval masses.

Associations

occasionally an ovarian yolk sac tumor can arise from a pre-existing ovarian dermoid cyst

Markers

affected patients have an elevated serum tumor marker AFP

Radiographic features

Typically, yolk sac tumors manifest as a large, complex pelvic mass that extends into the abdomen and contains both solid and cystic components. The cystic areas are composed of epithelial lined cysts produced by the tumor or of co-existing mature teratomas. Bilaterality is rare.

Ultrasound

Tends to have both echogenic and hypoechoic components .

MRI

They can be associated with prominent signal voids on MRI . Areas of hemorrhage can also be seen.

Treatment and prognosis

These tumors tend to grow rapidly and had a poor prognosis in the past, but now the prognosis has improved with the use of new therapies (platin or carboplatin, etoposide, bleomycin). Early lymphatic spread, as well as invasion, is common.