Abstract
Background : Ovarian mixed germ cell tumors are rare and occur primarily in young women. We report herein on the case of an ovarian mixed germ cell tumor composed of a yolk sac tumor (YST) and a mature cystic teratoma with elevated serum beta-human chorionic gonadotropin (hCG) levels.
Case : A 16-year-old girl presented with abdominal fullness. Pelvic magnetic resonance imaging revealed a 20 cm diameter solid tumor, and serum levels of alpha-fetoprotein and beta-hCG were elevated. Surgery was performed and a right ovarian tumor with metastasis to the left ovary and pelvic peritoneum was found. Histological examination of the right ovarian tumor revealed a YST associated with a mature cystic teratoma. According to cytological examination, “balloon animal”-like cell clusters were observed in the imprint specimens. On the other hand, acute-angled cytological atypia was observed in the ascitic fluid as well as the imprint specimens. Immunohistochemically, the syncytiotrophoblastic giant cells in the YST were positive for hCG.
Conclusion : In addition to hyaline globules, “balloon animal”-like cell clusters and acute-angled cytological atypia may play an important role in the diagnosis of YST.
