J Korean Soc Radiol.  2012 Jan;66(1):57-61. 10.3348/jksr.2012.66.1.57.

Primary Yolk Sac Tumor of the Omentum: Case Report

• Baek CK
• Oh YT
• Jung DC
• Bae YS

• KMID: 2208872
• DOI: http://doi.org/10.3348/jksr.2012.66.1.57

Abstract

A 32-year-old woman had been referred to our hospital for lower abdominal pain. Pelvic ultrasonography and magnetic resonance imaging revealed a huge solid mass with an internal cystic portion. The patient underwent a staging laparotomy and subsequent total abdominal hysterectomy with bilateral salpingo-oophorectomy, bilateral pelvic lymph nodes sampling, and total omentectomy. At staging laparotomy, a large omental mass was found. The tumor displayed the typical histological patterns observed in the yolk sac tumor. The alpha-fetoprotein (AFP) serum value on the 10th day after surgery was 11,576.67 IU/mL and decreased to 6.46 IU/mL after chemotherapy. At the end of the treatment, all the findings, including the AFP level, were normal. We report a case of primary yolk sac tumor of the omentum in a 32-year-old woman.

MeSH Terms

Abdominal Pain
Adult
alpha-Fetoproteins
Endodermal Sinus Tumor
Female
Humans
Hysterectomy
Laparotomy
Lymph Nodes
Magnetic Resonance Imaging
Omentum
Yolk Sac
alpha-Fetoproteins

Figure

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  Fig. 1 Ultrasonography of the omental yolk sac tumor in a 32-year-old woman. A. Pelvic ultrasonography reveals a huge heterogeneous echogenic solid mass with internal anechoic portion. B. Color Doppler ultrasound shows internal hypervascularity of the tumor.

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  Fig. 2 Magnetic resonance imaging (MRI) of the omental yolk sac tumor in a 32-year-old woman. A. Axial T1-weighted MR image shows a multi-lobulated solid and cystic pelvic mass with some areas of hemorrhage (asterisk). B. Axial T2-weighted MR image shows multi-lobulated solid and cystic mass with internal signal voids (arrowheads) within the tumor due to a rich vascular supply. C. Axial postcontrast MR image shows a striking enhancement of the mass except for the area of hemorrhage and cysts.

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  Fig. 3 Positron emission tomography computed tomography (PET-CT) of the omental yolk sac tumor in a 32-year-old woman. A. Post-contrast CT scan shows an enhancing multi-lobulated solid mass with an internal cystic and necrotic portion. B. PET shows intense FDG uptake in the solid portion of the tumor, which suggests a malignant tumor. Note.-FDG = fludeoxyglucose

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  Fig. 4 Histological feature of the omental yolk sac tumor in a 32-year-old woman. A. Histological evaluation of the specimen exhibits typical Schiller-Duval body (arrow, H&E × 100). B. Immunohistochemical staining shows a positive reaction with alpha-fetoprotein (× 100).

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