title: Alpha-fetoprotein-producing serous carcinoma of the uterus metastasizing to the ovaries, mimicking primary ovarian yolk sac tumor: a case report and review of the literature.
abstract: In the uterus, most alpha-fetoprotein (AFP) producing neoplasms belong to the categories of malignant mixed muellerian tumor, hepatoid carcinoma, and yolk sac tumor. We describe the case of a 44-year-old woman who presented with vaginal bleeding, pelvic mass, and preoperative elevated AFP serum level, clinically suggestive of a primary ovarian yolk sac tumor. However, histological examination revealed a uterine AFP-producing papillary serous carcinoma, which has metastasized to the ovaries. Upon review of the literature on primary endometrial neoplasms with AFP production, 2 categories with possibly different histogenesis and biological behavior become evident: the primary yolk sac tumor of the uterus in young patients (range, 24-49 years; mean, 34 years) and the common high grade endometrial carcinoma with yolk sac dedifferentiation or aberrant AFP production in elderly patients (range, 55-69 years; mean, 63.7 years). In addition to being only the second case of uterine AFP-producing papillary serous carcinoma, this case is unusual for its clinical and radiological presentation as well as the relatively young age of the patient.
authors.affiliation: Department of Pathology, Florida Hospital Orlando, Orlando, Florida, USA. tranguyentienanh@hotmail.com
authors.forename: Tien Anh N
authors.initials: TA
authors.lastname: Tran
authors.forename: Hannah B
authors.initials: HB
authors.lastname: Ortiz
authors.forename: Robert W
authors.initials: RW
authors.lastname: Holloway
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Bigsby
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Finkler
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor; D018240:Endodermal Sinus Tumor / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D018716:Molecular Mimicry; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000473:pathology* / Q000556:secondary; D014594:Uterine Neoplasms / Q000378:metabolism* / Q000473:pathology*; D000509:alpha-Fetoproteins / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins