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Yolk sac tumour is a germ cell tumour whose cells copy the yolk sac of an early embryo and make the protein alpha-fetoprotein, which is measured in the blood to track it. In adults it almost always occurs mixed with other non-seminoma components and is cured with cisplatin chemotherapy; the pure infant form is a different, gentler disease covered on the childhood page.
The 2016 WHO classification splits yolk sac tumour into a postpubertal type, derived from germ cell neoplasia in situ and almost always part of a mixed non-seminoma, and a prepubertal type, unrelated to GCNIS, that is the commonest malignant testicular tumour of infants (Moch 2016). It grows in reticular, microcystic, endodermal sinus (Schiller-Duval body), papillary, glandular, solid and other patterns, secretes alpha-fetoprotein, and stains for glypican-3 and SALL4. Its importance in adults extends beyond the primary: among 124 somatic-type malignancies arising from testicular germ cell tumours, 7 of 45 adenocarcinomas were reclassified as glandular yolk sac tumour on glypican-3 and alpha-fetoprotein positivity, supporting a frequent yolk sac origin of the glandular tumours that appear in late relapse (Am J Surg Pathol 2014). In 33 pure yolk sac tumours of boys aged 5 to 71 months, 24 were disease-free and 8 developed metastases, with size over 4.5 cm, rete or epididymal invasion and necrosis predicting a poor outcome in stage I (Am J Surg Pathol 2015).
How it differs from its parent: it is the alpha-fetoprotein-producing component of non-seminoma, so a raised AFP after treatment signals yolk sac elements; it is the usual source of the chemoresistant glandular late relapses; and its prepubertal type belongs on the childhood germ cell page rather than here.
How common: no separate incidence figure in the sources read.
Treatment: as non-seminoma by stage and risk group with BEP, and resection of residual masses; late relapses with somatic-type or glandular yolk sac elements are treated surgically because they respond poorly to chemotherapy (Am J Surg Pathol 2014).
A component of 38 of 64 mixed germ cell tumours in a marker study (Am J Surg Pathol 2004); pure yolk sac tumour is rare in adults and is the usual germ cell tumour of infants, where it has its own biology (Am J Surg Pathol 2015). No registry figure was found in the sources read.
Germ cell tumours drain along the spermatic cord to the para-aortic nodes high in the abdomen, not to the groin, which is why staging scans look at the retroperitoneum.
Same organ: Retroperitoneal germ cell tumour, Leydig cell tumour of the testis, Sertoli cell tumour of the testis, Spermatocytic tumour of the testis, Germ cell neoplasia in situ (GCNIS), Embryonal carcinoma of the testis, Choriocarcinoma of the testis, Testicular germ cell tumours, Seminoma, Non-seminomatous germ cell tumour, Germ cell tumours of childhood and adolescence (extracranial and CNS)
Treated as non-seminoma by stage and risk group with BEP and resection of residual masses; late glandular relapses are resected.
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Query for this cancer: (TITLE:"Yolk sac tumour of the testis, postpubertal type" OR ABSTRACT:"Yolk sac tumour of the testis, postpubertal type" OR TITLE:"Yolk sac tumour" OR ABSTRACT:"Yolk sac tumour" OR TITLE:"Yolk sac tumor" OR ABSTRACT:"Yolk sac tumor" OR TITLE:"Endodermal sinus tumour" OR ABSTRACT:"Endodermal sinus tumour" OR TITLE:"Endodermal sinus tumor" OR ABSTRACT:"Endodermal sinus tumor" OR TITLE:"Yolk sac tumour, postpubertal-type" OR ABSTRACT:"Yolk sac tumour, postpubertal-type") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Yolk sac tumour of the testis, postpubertal type, not a curated reading list.
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