Yolk sac tumor of the ovary during pregnancy: a case report.
BACKGROUND
There is a therapeutic dilemma for the pregnant patient with malignancy requiring chemotherapy.


METHODS
We had a case of a 30-year-old pregnant woman with a yolk sac tumor who underwent right salpingo-oophorectomy at 22 weeks gestation. Chemotherapy during pregnancy was postponed because of concern with the risks of the chemotherapy to the fetus. After the operation, L2 fraction of alpha-fetoprotein (AFP) depending on the affinity for Lens culinaris agglutinin (LCA) as an indicator for a maternal source of AFP had been detectable since 30 weeks gestation and elevated rapidly with advancing gestation. Tumor recurrence was confirmed clinically at 34 weeks gestation. She was induced, delivering a healthy baby, and received seven complete chemotherapy courses (cisplatin, etoposide, and peplomycin). Currently, the mother (39 months after last chemotherapy) and child are doing well.


CONCLUSIONS
AFP-L2 may be a sensitive indicator for a yolk sac tumor derived AFP, leading to an earlier detection of tumor recurrence during pregnancy.
Aoki
Yoichi
Y
Division of Molecular Genetics, Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan. yoichi@med.niigata-u.ac.jp
Higashino
Masahiko
M
Ishii
Shiro
S
Tanaka
Kenichi
K
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D018240:Endodermal Sinus Tumor / Q000097:blood / Q000188:drug therapy; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000097:blood / Q000188:drug therapy; D017663:Peplomycin / Q000008:administration & dosage; D037121:Plant Lectins; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000097:blood; D000509:alpha-Fetoproteins / Q000378:metabolism
D037121:Plant Lectins; D000509:alpha-Fetoproteins; C033619:lentil lectin; D017663:Peplomycin; D005047:Etoposide; D002945:Cisplatin