title: Clinical stage I pure yolk sac tumor of the testis in adults has different clinical behavior than juvenile yolk sac tumor.
abstract: OBJECTIVE
  We evaluated the clinical behavior of clinical stage I pure yolk sac tumor of the testis in adults to determine whether the behavior of this entity is different than that of clinical stage 1 nonseminoma.
  
  
  METHODS
  We searched the testis cancer database at our institution for adults with clinical stage I pure yolk sac tumor of the testis who underwent retroperitoneal lymph node dissection. We identified 12 such patients and reviewed the database and hospital charts to determine clinical behavior.
  
  
  RESULTS
  Disease was pathological stage I in 8 of the 12 patients (66%), including 1 with recurrence after retroperitoneal lymph node dissection. Disease was pathological stage II in 14 patients (33%), including 1 who remains disease-free after electing adjuvant bleomycin, etoposide and cisplatin. Of the 3 patients who elected observation after retroperitoneal lymph node dissection only 1 has had recurrence, while 2 (66%) were cured by retroperitoneal lymph node dissection only.
  
  
  CONCLUSIONS
  Contrary to juvenile yolk sac tumor, which has a strong tendency toward hematogenous metastasis, the behavior of clinical stage I adult pure yolk sac tumor is similar to that of all other stage I nonseminomas in adulthood.
authors.affiliation: Department of Urology, Indiana University Medical Center, Indianapolis, Indiana, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Foster
authors.forename: B
authors.initials: B
authors.lastname: Hermans
authors.forename: R
authors.initials: R
authors.lastname: Bihrle
authors.forename: J P
authors.initials: JP
authors.lastname: Donohue
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018240:Endodermal Sinus Tumor / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009919:Orchiectomy; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000473:pathology* / Q000628:therapy