2023 Volume 41 Issue 2 Pages 242-249
YSTs rarely occur in postmenopausal women, and they often coexist with epithelial ovarian tumor. We report a case of postmenopausal YST, which was difficult to make a histological diagnosis. A 67 years old woman had acute abdominal pain, and she was diagnosed with a ovarian tumor rupture. We performed emergency surgery, and the tumor was pathologically diagnosed as YST stage IC2. We started chemotherapy of the BEP regimen immediately, and the AFP level decreased into normal range by the end of the first cycle. In consideration of her age and the possibility of epithelial tumor origin, we performed detailed immunohistochemistry. The mucinous component which consists of major part of the tumor, was intestinal-type and positive for CDX2, p53. A small solid component where YST was suspected, AFP, SALL4, CDX2 and p53 were positive. She experienced severe bone marrow suppression after 1st cycle, so we changed the regimen to Paclitaxel and Carboplatin from 2nd cycle. She had been relapse-free at 17 months postoperatively.
Recently, YSTs in postmenopausal women considered to be somatic YST which is derived from epithelial neoplasm. In postmenopausal YST, we should consider somatic YST in making a diagnosis and choosing a chemotherapy regimen.
