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Updated: Jun 15, 2026
Surgical Treatment of an Endolymphatic Sac Tumor
Published on: May 26, 2023
Vaginal yolk sac (endodermal sinus) tumors in infancy presenting persistent vaginal bleeding
Noriko Watanabe1, Hajime Okita, Kentaro Matsuoka
1Division of Pathology, National Center for Child Health and Development, Tokyo, Japan. nolikow@nifty.ne.jp
Insights
This study reports on two young girls diagnosed with vaginal yolk sac tumors, a rare cancer. Effective treatment with chemotherapy led to tumor reduction and positive outcomes for both patients.
Area of Science:
- Gynecologic Oncology
- Pediatric Oncology
- Pathology
Background:
- Vaginal yolk sac tumors (endodermal sinus tumors) are rare malignancies in pediatric patients.
- Persistent vaginal bleeding is a primary clinical manifestation requiring prompt investigation.
Observation:
- Two girls, aged 12 and 46 months, presented with isolated vaginal bleeding.
- Imaging studies revealed solitary vaginal masses, with serum alpha-fetoprotein levels varying between patients.
- Diagnostic biopsies confirmed the presence of yolk sac tumors.
Findings:
- Combination chemotherapy regimens, including cisplatin, etoposide, and bleomycin or carboplatin, were administered.
- Significant tumor size reduction and normalization of alpha-fetoprotein levels were observed post-chemotherapy.
- Histopathological examination post-treatment indicated no viable tumor cells in one patient, and no visible tumor in the other.
Implications:
- Vaginal yolk sac tumors, despite their rarity, are treatable with chemotherapy in pediatric patients.
- Multimodal imaging and tumor marker monitoring are crucial for diagnosis and response assessment.
- Successful treatment offers a favorable prognosis, with patients remaining well post-therapy.
Abstract:
Vaginal yolk sac (endodermal sinus) tumors were diagnosed in two girls (ages 12 and 46 months). In both, the only manifestation was persistent vaginal bleeding. Pelvic ultrasonography, computed tomography, and magnetic resonance imaging revealed solitary vaginal masses (diameter, 5 and 2 cm, respectively). Serum alpha-fetoprotein was highly elevated in one patient and normal in the other. Biopsy was performed in the first patient, and a tumor excision, in the second. Combination chemotherapy with cisplatin, etoposide, and bleomycin or carboplatin was administered to the first patient, and shortly thereafter, the tumor size decreased by more than half; serum alpha-fetoprotein was normalized after four chemotherapy cycles. After chemotherapy, magnetic resonance imaging revealed a small residual lesion, however the second biopsy revealed no viable tumor cells. In the second patient, no visible tumor was observed after chemotherapy by vaginoscopy. Both patients are well at 19 and 14 months after diagnosis, respectively.
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