Endodermal sinus tumour of the ovary: the place of alphafetoprotein detection, surgery and chemotherapy

New developments in the management of the rare endodermal sinus tumour of the ovary, together with the reporting of 2 additional patients, are presented. There is a need for accurate clinical and pathological evaluation of the disease. As shown in the present study, histochemical staining for alphafetoprotein (AFP) provides an additional factor in diagnosis, and monitoring of AFP levels in serum is a useful guide to treatment. The prognosis, previously uniformly poor, appears to be improved with the use of multidrug chemotherapy. In a collated series of 98 patients, the 24-month survival rate was 65% in Stage I disease and 67% in Stage II disease. However, the choice of effective drugs remains uncertain. The improved survival of young patients with aggressive chemotherapy has now raised the question of preservation of fertility at the time of surgery. In a small collated series of 26 patients with Stage I disease, survival to 36 months was not jeopardized by the conservative removal of one tube and ovary.