Immature Teratoma with Components of a Yolk-Sac Tumour

Abstract

Immature teratoma (IMT) is an ovarian germ cell tumour with high malignant potential. It is occasionally combined with other ovarian germ cell malignancies, but rarely just with yolk-sac tumour, which exhibits even more aggressive behaviour. We present a case of a young patient who presented with giant, atypical, steady growing tumour comprised of IMT with YST islets. Throughout adolescence the tumour grew to gigantic measures of almost 7, 2 kg, without any symptoms, and secreting no significant quantities of alpha-fetoprotein (AFP), which is the major biomarker for YST. In spite of a huge abdominal tumour, giving her body contour characteristics of a late third trimester pregnancy, the disease was fortunately in FIGO Ia stage, enabling the patient to choose the conservative treatment of fertility sparing surgery alone. The recovery was complete, with defined frequent follow-up sessions. Given that almost all of mixed malignant ovarian germ cell tumours (MOGCTs) are highly chemo-sensitive, potential neo-adjuvant chemotherapy remains an alternative treatment if the signs of recurrence appear. Today’s golden standard in chemotherapy for MOGCTs presents a BEP (bleomycine, etoposide, and cisplatin) regimen. After thorough search of recent literature we present a review of novel insights in aetiology, diagnostics and treatment options for this rare group of cancers.