[Endodermal sinus tumor--a contribution to the clinical aspects of ovarian tumors]

Two cases of endodermal sinus tumor (EST) are described in a 19-year-old girl and a 50-year-old menopausal women, respectively. Exstirpation uteri totalis cum adnexis was carried out in both cases. According to the FIGO the tumors were classified as Ic. The histologic diagnosis of EST was based on the presence of elements such as extraembryonic mesoderm, yolk sac mesoderm, vascular structures with Schiller-Duval bodies, PAS-positive globules in Duval sinus spaces. In the first case, where the proposed chemotherapy was refused, the patient died 4 months later with symptoms of abdominal metastases. In the other case, chemotherapy was applied according to the VAC program. At 13 months of the treatment a relaparotomy was made and the lymphatic nodes taken showed no metastases. Three months later, the tumor relapsed and the patient died at 22 months of the therapy. In the light of their observations and literature data the authors recommended a radical surgical intervention combined with intense polychemotherapy as the only effective approach to the problem.