Ovary tumor
Germ cell tumors
Yolk sac tumor

Authors: Shahrzad Ehdaivand, M.D. (see Authors page)

Revised: 3 June 2016, last major update December 2012

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed search: ovarian yolk sac tumor
Cite this page: Yolk sac tumor. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumoryolksac.html. Accessed June 21st, 2018.
Definition / general
  • Also called endodermal sinus tumor
  • May be derived from embryonal carcinoma
  • Usually children or young adults (median age 19 years) with abdominal pain and rapidly growing mass, increasing alpha fetoprotein (AFP) and alpha-1-antitrypsin serum levels; negative hCG
  • Fatal without chemotherapy since most have subclinical metastases at presentation
Case reports
Gross description
  • Mean 15 cm, smooth and glistening external surface, cystic cut surface with hemorrhage and necrosis
  • Often has benign teratoma component; rarely is found in pelvis unattached to ovary
Gross images

Images hosted on PathOut server:

Solid, fleshy, cystic, necrosis, gelatinous degeneration

Polyvesicular-vitelline variant (honeycomb appearance)

Microscopic (histologic) description
  • Numerous patterns
  • Schiller-Duval body is pathognomonic - central blood vessel enveloped by germ cells within a space similarly lined by germ cells, resembles glomerulus
  • Hyaline droplets present in all tumors (positive for AFP, PAS and alpha-1-antitrypsin)
  • Patterns:
    • Reticular or microcystic patterns formed by a loose network of flat / cuboidal cells
    • Polyvesicular vitelline pattern: in 25%; vesicular structures with eccentric constrictions surrounded by a dense spindle cell stroma; may have better prognosis in pure form
    • Other patterns: endometrioid (rare, Am J Surg Pathol 1987;11:767), hepatoid (large polyhedral cells with hyaline bodies but no bile, resembles metastatic hepatocellular carcinoma), glandular (may be cribriform or resemble endometrioid carcinoma), intestinal differentiation, parietal (thick layers of basement membrane), solid, undifferentiated
Microscopic (histologic) images

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Images hosted on PathOut server:

Loose stroma

Schiller-Duval bodies

Hyaline bodies

Myxoid stroma

Polyvesicular-vitelline pattern

Hepatoid variant

Glandular variant, intestinal type

Resembling serous carcinoma

Parietal pattern

Solid pattern

Papillary pattern (above) with reticular pattern (below)

Microcystic pattern

Endometrioid-like glandular variant

Contributed by Dr. Debra Zynger, Ohio State University

Various images

Various images

Various images

Various images

Images hosted on other servers:

Yolk sac

Schiller Duval

AFP stain

Positive stains
  • Keratin, AFP (yolk sac elements, hepatic or intestinal epithelium in teratomas) and CD10
Molecular / cytogenetics description
  • Usually aneuploid or tetraploid