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Case Reports
. 2025 Jun 9:59:101778.
doi: 10.1016/j.gore.2025.101778. eCollection 2025 Jun.

Fertility preserving, uterine sparing approach to a uterine extragonadal yolk sac tumor

Michelle Greenman  1 , Blair McNamara  1 , Victoria Ettorre  1 , Natalia Buza  2 , Masoud Azodi  1
Affiliations
Case Reports

Fertility preserving, uterine sparing approach to a uterine extragonadal yolk sac tumor

Michelle Greenman et al. Gynecol Oncol Rep. .

Abstract

Objectives: Treatment of a uterine extragonadal yolk sac tumor (EGYST) typically requires hysterectomy. Fertility preserving strategies are essential for young women who have not yet met their reproductive goals. Here we explore an option for uterine preservation.

Methods: A 30-year-old presented with what was thought to be a degenerating fibroid but ultimately was diagnosed as an extragonadal yolk sac tumor. The myometrium and endometrium adjacent to the tumor were resected with negative margins, the uterus was reconstructed, and a fertility preserving staging procedure was performed followed by chemotherapy with bleomycin, etoposide, and cisplatin. She had a single recurrence which was surgically managed.

Results: The patient has had no evidence of disease for the past six years since the recurrence was diagnosed. The patient has since spontaneously conceived pregnancy.

Conclusion: This case successfully presents a surgical approach to managing a uterine extragonadal yolk sac tumor in a young woman that desired future fertility. A uterine wedge resection and reconstruction was able to adequately resect the tumor. This represents a treatment option for uterine preservation in women that have not yet completed childbearing.

Keywords: Extragonadal yolk sac tumor; Fertility preservation; Germ cell tumor.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
MRI showing uterine mass characterized as a degenerating fibroid A. Sagittal view B. Axial view.
Fig. 2
Fig. 2
Microscopic features of extragonadal yolk sac tumor from the first surgical resection. A. Glandular architecture with marked nuclear atypia and focal cystoplasmic clearing (H&E stain). B. AFP immunostain is diffusely positive in tumor cells (AFP immunostain).
See this image and copyright information in PMC

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