High-Grade Serous Carcinoma Of Fallopian Tube With Yolk Sac Tumor Differentiation In A Postmenopausal Patient

Yolk sac tumors (YSTs) are the second most common germ cell malignancy of the ovaries, generally pre-senting in children and young women. However, they rarely occur in the fallopian tubes of postmenopausal patients. The current rare case is composed of yolk sac tumor differentiation within high-grade serous carcinoma (HGSC) arising in the fallopian tube of a 68-year-old woman. Serum alpha-fetoprotein was much higher than normal level. This case exhibited some areas of glandular architecture with positivity for SALL4, AFP, and Glypican-3 and negative staining for PAX8, supporting a germ cell tumor differentiation. By reviewing the published literature, we believe that YSTs, whether or not associated with an epithelial component detected histologically in older patients, constitute a single entity that is different from YSTs in younger patients. Above all, the pathologist must check carefully tissue stained with hematoxylin-eosin especially in postmenopausal women with ovarian, fallopian tube, or endometrial mass and an elevated serum alpha-fetoprotein level. Neoplasms of this type should be treated aggressively, and should respond to platinum-based chemothotherapy.