Secondary Cytoreductive Surgery for Primary Yolk Sac Tumor Arising from the Omentum

Abstract

Background: Yolk sac tumors arising from the omentum in women are very rare. There is no established treatment strategy for them. We report the first case of a yolk sac tumor arising from the omentum, which was successfully removed with secondary surgery after chemotherapy. Case: A 34-year-old Japanese woman visited our hospital with a large, solid, pelvic mass detected by magnetic resonance imaging (MRI) and a highly elevated serum alpha-fetoprotein. At primary laparotomy, a large, friable, and hemorrhagic mass adhered to the omentum was found. Histopathological examination of the resected specimen from the mass revealed a yolk sac tumor. Four cycles of bleomycin, etoposide, and cisplatin (BEP) combination chemotherapy were administered every 3 weeks. After chemotherapy, an MRI showed a residual pelvic mass 8cm in diameter. We performed secondary cytoreductive surgery and completely resected the residual tumor. At secondary laparotomy, a residual omental mass was found. Conclusions: Secondary cytoreductive surgery after the chemotherapy is one of the possible treatment strategies for an omental yolk sac tumor. (J GYNECOL SURG 29:52)