glandular pattern ovarian yolk sac tumor

The glandular pattern in ovarian yolk sac tumors is characterized by the presence of columnar tumor cells that form simple tubules with round/oval lumen or complex anastomosing glandular structures [3][4]. This pattern may be focal or more widespread, and the glands may merge with the vesicles of polyvesicular vitelline pattern or may be present in a myxomatous, microcystic, or solid background [5].

In approximately one-third of cases, ovarian yolk sac tumors exhibit a glandular-alveolar pattern, where columnar tumor cells form simple tubules with round/oval lumen or complex anastomosing glandular structures [6]. This pattern is often admixed with other histological features, such as solid sheet-like, papillary, and myxoid patterns.

The glandular pattern in ovarian yolk sac tumors can be a diagnostic challenge, as it may resemble other types of ovarian tumors. However, the presence of this pattern, along with other characteristic features such as polyvesicular vitelline structures and Schiller-Duval bodies, can help to establish a diagnosis of yolk sac tumor [7].

It's worth noting that the glandular pattern in ovarian yolk sac tumors is not unique to this type of tumor, and similar patterns can be seen in other types of germ cell tumors. Therefore, a comprehensive histological examination and clinical correlation are essential for an accurate diagnosis [8].

Common Signs and Symptoms of Glandular Pattern Ovarian Yolk Sac Tumor

Glandular pattern ovarian yolk sac tumors are a rare type of cancer that can present differently depending on their location. According to medical literature, the following signs and symptoms are commonly associated with this condition:

• Abdominal distention: A feeling of fullness or swelling in the abdominal area due to the tumor's growth.
• Sudden onset of pain: Patients may experience sudden and severe abdominal pain as the tumor grows rapidly.
• Large abdominopelvic mass: The tumor can grow to a significant size, causing discomfort and pain.

It is essential to note that these symptoms can vary in severity and presentation depending on individual cases. If you or someone you know is experiencing any of these symptoms, it is crucial to seek medical attention promptly.

Additional Information

• In about one-third of cases, glandular pattern ovarian yolk sac tumors may exhibit a glandular-alveolar pattern, where columnar tumor cells form simple tubules with round/oval lumen or complex anastomosing glandular structures.
• The presence of myxoid stroma can also be observed in some cases.

References

[12] Common Signs and Symptoms. Yolk sac tumors (YSTs) can present differently depending on their location. ... Ovarian yolk sac tumors typically present with similar histological patterns as their testicular counterparts. However, they may also exhibit a glandular-alveolar pattern in about one-third of cases. [13] Glandular pattern in Yolk Sac Tumor (one-third of cases): Columnar tumor cells form simple tubules with round/oval lumen or complex anastomosing glandular structures.The pattern may be focal or more widespread. The glands may merge with the vesicles of polyvesicular vitelline pattern or may be present in a myxomatous, microcystic, or solid background. [15] A usually rapidly growing malignant germ cell tumor arising from the ovary. It usually occurs in children and adolescents. Signs and symptoms include abdominal pain and a large abdominal or pelvic mass. The serum alpha-fetoprotein is almost always elevated preoperatively. Morphologically, there is marked heterogeneity due to numerous patterns of differentiation coexisting in the same tumor.

Diagnostic Tests for Glandular Pattern Ovarian Yolk Sac Tumor

The diagnosis of a glandular pattern ovarian yolk sac tumor can be challenging due to its rarity and varied histological features. However, several diagnostic tests can help establish the correct diagnosis.

• Immunohistochemical staining: Immunohistochemistry is a valuable tool in diagnosing yolk sac tumors. The most useful stain for this purpose is alpha-fetoprotein (AFP), which is typically diffusely positive in yolk sac tumors [5][6]. Additionally, placental alkaline phosphatase (PLAP) and glypican 3 can also be used to establish the diagnosis [7].
• Microscopic examination: Microscopic examination of the tumor tissue is essential for diagnosing a glandular pattern ovarian yolk sac tumor. The presence of solid-sheet growth patterns, papillary, and glandular structures are characteristic features of this type of tumor [12][13]. It's also important to rule out other types of tumors that may have similar histological features.
• Serum alpha-fetoprotein (AFP) levels: Elevated serum AFP levels can be a useful indicator of yolk sac tumor, although not all cases will show elevated levels. A combination of clinical information and tumor markers can aid in diagnosing ovarian YSTs [9].
• Imaging studies: Imaging studies such as ultrasound or CT scans may be used to assess the size and location

Based on the search results, it appears that the standard treatment for ovarian yolk sac tumors includes a combination of surgery and chemotherapy.

• According to search result [4], with a combination of modern surgical treatment and adjuvant chemotherapy (cisplatin-based), survival in those with yolk sac tumors (YSTs) is significantly improved.
• Search result [5] mentions that chemotherapy is currently indicated in all cases postoperatively, suggesting that drug treatment plays a crucial role in the management of ovarian yolk sac tumors.
• Search result [8] states that the standard treatment of malignant ovarian germ cell tumors, which includes ovarian yolk sac tumors, is fertility-preserving surgery and three to four cycles of combination chemotherapy.

Regarding the specific treatment for glandular pattern ovarian yolk sac tumor, it's worth noting that search result [10] mentions a study on solid pattern yolk sac tumor, but does not provide information on glandular pattern specifically. However, given the similarity in histological patterns, it is likely that the treatment approach would be similar.

Based on the available information, it appears that the standard treatment for ovarian yolk sac tumors, including those with a glandular pattern, involves a combination of surgery and chemotherapy. The specific chemotherapeutic agents used may include cisplatin-based regimens, as mentioned in search results [4] and [5].

• A combination of modern surgical treatment and adjuvant chemotherapy (cisplatin-based) is effective for improving survival in ovarian yolk sac tumors [4].
• Chemotherapy is currently indicated in all cases postoperatively, suggesting that drug treatment plays a crucial role in the management of ovarian yolk sac tumors [5].

It's essential to consult with a medical professional or a gynecologic oncologist for personalized advice on the treatment of glandular pattern ovarian yolk sac tumor.

References: [4] Dec 29, 2021 — With a combination of modern surgical treatment and adjuvant chemotherapy (cisplatin-based), survival in those with yolk sac tumors (YSTs) is ... [5] Chemotherapy is currently indicated in all cases postoperatively (Tables 27-6 and 27-7). In 85% of patients with stage I disease treated with surgery alone, ...

The differential diagnosis for a glandular pattern ovarian yolk sac tumor includes several entities that can mimic its histological appearance.

• Clear cell carcinoma: This type of cancer is known to display a similar glandular or tubular pattern, making it challenging to distinguish from a glandular pattern yolk sac tumor (YST) [1][2].
• Serous carcinoma: Serous carcinomas can also exhibit gland-like structures, which may be confused with the glandular pattern seen in YSTs [3].
• Müllerian mixed tumor: This rare type of cancer can display a mix of epithelial and mesenchymal components, including gland-like structures, that may resemble the glandular pattern in YSTs [4].

It's worth noting that the presence of elevated serum AFP levels is often associated with yolk sac tumors, but this marker is not specific to YSTs and can be elevated in other types of cancers as well [5]. Therefore, a comprehensive histopathological examination and immunohistochemical studies are essential for accurate diagnosis.

In addition, the differential diagnosis may also include embryonal rhabdomyosarcoma (sarcoma botryoides) on gross examination, and clear cell carcinoma on microscopic examination [6].

A thorough understanding of these entities and their characteristic features is crucial for accurate diagnosis and treatment planning.