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Endodermal sinus tumor

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Yolk sac tumours are members of the germ cell tumour group of ovarian neoplasms. Almost all ovarian yolk sac tumours occur in women under the age of 30. Patients usually present with sudden onset pain and a large pelvic mass. Serum alpha-fetoprotein (AFP) is elevated in virtually all cases and is the prototypic serum marker for ovarian tumours in young patients. At laparotomy, there is spread to the peritoneum or lymph nodes in 30-70% of cases.

The tumours are soft and friable with a smooth external surface and a cystic and perhaps solid variegated yellow or gray sectioned surface. Extensive hemorrhage and necrosis is usual.

Microscopically, there is a wide variety of patterns and several histologic subtypes. Typical features are Schiller-Duval bodies and eosinophilic hyaline globules. Before contemporary chemotherapy, this type of neoplasm was highly lethal, but the prognosis has significantly improved since.