Neoadjuvant Chemotherapy in the Management of Extraovarian Yolk Sac Tumor: A Case Report and A Review of the Literature

Extraovarian yolk sac tumor (YST) is an extremely rare malignancy occurring mainly in girls and young women of childbearing ages and commonly treated with fertility-sparing surgery and postoperative adjuvant chemotherapy. We report a case treated with neoadjuvant chemotherapy (NACT) followed by cytoredutive surgery and adjuvant chemotherapy. A 32-year-old single woman came for a second opinion following explorative laparotomy secondary to pelvic mass and histologic results of an undetermined malignancy. Our evaluation revealed a yolk sac tumor involving the cecum with a cutaneous fistula and pelvic infection. The patient was treated with three courses of Bleomycin, Etoposide and Cisplatin (BEP) followed by an optimal cytoreductive surgery and another two courses of Etoposide and Platinum-AQ (EP). There is no evidence of disease during a two years follow-up. Conclusion: NACT followed by fertility sparing surgery should be considered as an alternative to primary debulking surgery in advanced YSTs.