Endometrial Yolk Sac Tumor with Omental Metastasis

To the Editor: A 38‐year‐old woman presented at our hospital with a complaint of hypermenorrhea lasting 2 months. No symptoms were found by bimanual examination, and vaginal ultrasound showed endometrial thickness of 4 mm. Diagnostic curettage strongly suggested clear‐cell adenocarcinoma. Magnetic resonance imaging of the pelvis showed an intact endometrial binding zone with no extrauterine infiltration. Other laboratory examinations were normal; serum alpha‐fetoprotein (AFP) level was not determined at admission. Exploratory laparoscopy was performed under general anesthesia. Radical surgery was performed involving total hysterectomy, bilateral salpingo‐oophorectomy, pelvic and abdominal aortic lymphadenectomy, and omental resection. All surgical specimens were analyzed carefully. A tumor measuring 2.5 cm × 1.5 cm × 1.5 cm was found in the left corner of the posterior uterine cavity [Figure 1a]. Several metastatic nodules with a diameter of 1.0 cm were found in the omentum. No other metastases were found in the abdominal cavity. All pelvic and abdominal aortic lymph nodes were normal. Pelvic washes were negative for tumor cells.