Fertility preserving, uterine sparing approach to a uterine extragonadal yolk sac tumor.

OBJECTIVES

Treatment of a uterine extragonadal yolk sac tumor (EGYST) typically requires hysterectomy. Fertility preserving strategies are essential for young women who have not yet met their reproductive goals. Here we explore an option for uterine preservation.

METHODS

A 30-year-old presented with what was thought to be a degenerating fibroid but ultimately was diagnosed as an extragonadal yolk sac tumor. The myometrium and endometrium adjacent to the tumor were resected with negative margins, the uterus was reconstructed, and a fertility preserving staging procedure was performed followed by chemotherapy with bleomycin, etoposide, and cisplatin. She had a single recurrence which was surgically managed.

RESULTS

The patient has had no evidence of disease for the past six years since the recurrence was diagnosed. The patient has since spontaneously conceived pregnancy.

CONCLUSION

This case successfully presents a surgical approach to managing a uterine extragonadal yolk sac tumor in a young woman that desired future fertility. A uterine wedge resection and reconstruction was able to adequately resect the tumor. This represents a treatment option for uterine preservation in women that have not yet completed childbearing.