关键词: 绝经后期, 内胚层窦瘤, 甲胎蛋白类, 免疫组织化学, 肿瘤辅助疗法

Abstract:

One case of yolk sac tumor with primary endometrium in a postmenopausal woman was reported. The patient was a 57-year-old woman with postmenopausal vaginal bleeding, accompanied by the elevated level of serum tumor marker alpha-feto protein(AFP). Gynecological ultrasound showed the thickening endometrium and uneven echo, abundant blood flow, and a right uterine cavity mass lesion. Pelvic magnetic resonance imaging showed the abnormal signal shadows in the myometrium and intrauterine cavity. On January 2, 2024, the patient underwent transabdominal total hysterectomy + double salpingectomy + pelvic and abdominal para-aortic lymph node dissection + omentectomy, and the postoperative pathological results suggested endometrial yolk sac tumor. As of May 2024, the patient has undergone 6 rounds of chemotherapy and is generally in good condition, with no recurrence or metastasis. The primary endometrial yolk sac tumor in postmenopausal women is highly malignant, with poor prognosis and the non-specific clinical manifestations. The diagnosis mainly depends on pathological examination and immunohistochemical examination. The early detection, early diagnosis and individualized treatment plan are the key factors to improve the prognosis of patients.

Key words: Postmenopause, Endodermal sinus tumor, Alpha-fetoproteins, Immunohistochemistry, Neoadjuvant therapy