A rare case of a giant ovarian yolk sac tumor during late pregnancy is reported, shedding light on the challenges and complexities of diagnosing and treating such conditions in pregnant women. Yolk sac tumors are highly malignant germ cell tumors that pose unique challenges in pregnancy due to physiological changes and limitations in diagnostic tools.
The case involves a 28-year-old pregnant woman whose pregnancy was terminated at 29 weeks and 5 days due to lower abdominal pain and the discovery of a pelvic mass. Elevated tumor markers such as serum alpha-fetoprotein and cancer antigen levels raised suspicion of malignancy. Imaging confirmed the presence of a large pelvic mass, leading to a cesarean section and subsequent surgical interventions including omentectomy, adnexectomy, and lymph node dissection.
Postoperative pathology confirmed the presence of a yolk sac tumor of the ovary, prompting a five-cycle chemotherapy regimen. The patient’s response to treatment was positive, with a significant decrease in tumor markers and improved overall condition. The case highlights the importance of early detection, timely intervention, and multidisciplinary management in achieving favorable outcomes for both the mother and the newborn.
Ovarian yolk sac tumors, characterized by yolk sac differentiation, account for a small percentage of ovarian malignancies and are associated with poor prognosis. The pathological features, clinical manifestations, and treatment options for these tumors are complex, requiring a comprehensive approach to diagnosis and management.
Diagnosing yolk sac tumors during pregnancy presents additional challenges due to physiological changes and limitations in tumor marker interpretation. Continuous monitoring, dynamic imaging techniques such as ultrasound and MRI, and careful assessment of clinical symptoms are essential for accurate diagnosis and treatment planning.
Surgical resection remains the primary treatment modality for yolk sac tumors, with a focus on preserving reproductive function in young patients. Postoperative chemotherapy, such as the BEP regimen, is recommended to prevent recurrence and improve outcomes. Close monitoring of tumor markers and timely adjustments to treatment protocols are crucial for optimizing patient outcomes.
In conclusion, the management of ovarian yolk sac tumors during pregnancy requires a multidisciplinary approach, considering the unique challenges posed by pregnancy status. Early diagnosis, timely intervention, and individualized treatment strategies are essential for achieving positive outcomes for both the mother and the fetus.
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