Paediatric Pathology Online
Pathology of Yolk Sac Tumour
Schiller-Duval bodies are diagnostic of yolk sac tumor
Testicular and paratesticular and ovarian tumours are rare in childhood, representing 1-2 percent of the solid tumours in the pediatric age.
The evolution differs from that of the adult.
Yolk sac tumour most commonly affects the testis and ovaries.
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For the first two years after birth it constitutes the most common form of testicular neoplasm.
Extragonadal locations include the vagina, sacrococcygeal area, pelvis, retroperitoneum, anterior mediastinum and pineal area. Rare cases have been reported in the kidney, heart and rectum.
Microscopically, yolk sac tumor expresses variable cellular patterns, including "reticular", "polyvesicular vitelline", "pseudopapillary" and "solid pattern".
Co-existence of these patterns in the same tumour in varying combination is commonly seen.
Schiller-Duval bodies are diagnostic of yolk sac tumor but are only found in some 50% to 75% of neoplasms. They are found more commonly in association with pseudopapillary pattern.
Patients with yolk sac tumors invariably have a raised serum alpha-fetoprotein level.
The single most important factor in prognosis is completeness of surgical excision and is probably the basis of the excellent outlook for tumours of the testes, contrasting with yolk sac tumours occurring at other sites.
There is no correlation between prognosis and histological pattern.
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