Ovarian Mucinous Carcinoma with a Yolk sac Tumor-Like Component: A Report of Three Cases with a Literature Review for Prognostic Analysis

Int J Surg Pathol. 2023 Aug;31(5):765-771. doi: 10.1177/10668969221133346. Epub 2022 Oct 30.

Abstract

The most common subtype of ovarian carcinoma associated with somatically derived yolk sac tumor (YST) is endometrioid carcinoma. Only two cases of ovarian mucinous carcinomas associated with YST have been reported; herein, we present three additional patients, along with a review of previous literature and our pathology archives to analyze the tumor prognosis. The patients' ages ranged from 38 to 53 years. Two patients had FIGO stage 1 tumors, and one patient had a stage 3 tumor. Two patients died of the disease within a year, and one patient survived with distant metastasis (32 months after surgery). In all three tumors, the YST-like component comprised less than 5% of the total tumor area. Together with the two previously reported mucinous carcinomas with a YST-like component, the prognosis of the five mucinous carcinomas with a YST-like component were compared with that of 19 conventional mucinous carcinomas resected at our hospital. The survival curves were estimated using the Kaplan-Meier method. As a result, the overall survival rate of patients with mucinous carcinomas with a YST-like component was significantly lower than that of patients with conventional mucinous carcinomas (P = .0014). Our study indicates that the presence of a YST-like component in mucinous carcinomas would be a strong prognostic indicator.

Keywords: AFP; SALL4; ovarian mucinous carcinoma; p53; somatically derived yolk sac tumor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma, Mucinous* / diagnosis
  • Adenocarcinoma, Mucinous* / surgery
  • Adult
  • Carcinoma, Endometrioid* / pathology
  • Carcinoma, Ovarian Epithelial
  • Endodermal Sinus Tumor* / diagnosis
  • Endodermal Sinus Tumor* / surgery
  • Female
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Ovarian Neoplasms* / diagnosis
  • Ovarian Neoplasms* / pathology
  • Ovarian Neoplasms* / surgery
  • Prognosis