{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T04:36:25Z","timestamp":1770266185533,"version":"3.49.0"},"reference-count":10,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,21]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>This case report documents an extremely rare presentation of primary uterine yolk sac tumour (YST) in a premenopausal woman in her late 40s, who presented with heavy menstrual bleeding. Imaging was suggestive of a uterine tumour with rising serum germ cell markers. In the absence of preoperative histology, a surgical staging was performed, confirming pathological diagnosis and immunohistochemistry (SALL4 and alpha-fetoprotein (AFP) positive). She received adjuvant chemotherapy as per protocol. With a short disease-free interval, she had a rise in serum AFP with recurrence in the lungs, which was successfully treated with second-line chemotherapy. This case uniquely highlights the importance of comprehensive tumour marker assessment, the role of marker-guided surveillance in early relapse detection, and demonstrates the feasibility of successful salvage therapy. The case expands current knowledge of extragonadal YST management, encourages vigilance for atypical presentations and underscores the value of individualised multimodality care\u2014even in aggressive, relapsed disease\u2014for achieving complete remission.<\/jats:p>","DOI":"10.1136\/bcr-2025-269276","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T14:55:53Z","timestamp":1770216953000},"page":"e269276","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Primary uterine yolk sac tumour: a rare and aggressive malignancy \u2013 navigating diagnostic uncertainty and treatment pathway"],"prefix":"10.1136","volume":"19","author":[{"given":"Jayashree","family":"Natarajan","sequence":"first","affiliation":[{"name":"Gynecology Oncology, Cancer Institute WIA and Research Centre, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7259-5318","authenticated-orcid":false,"given":"Anand","family":"Murali","sequence":"additional","affiliation":[{"name":"Surgical Oncology, Cancer Institute WIA and Research Centre, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkatraman","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Medical Oncology, Cancer Institute WIA and Research Centre, Chennai, Tamil nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2585-8527","authenticated-orcid":false,"given":"Anand","family":"Raja","sequence":"additional","affiliation":[{"name":"Surgical Oncology, Cancer Institute WIA and Research Centre, Chennai, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"2026020406551400000_19.2.e269276.1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23792"},{"key":"2026020406551400000_19.2.e269276.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.gore.2021.100748","article-title":"Yolk sac tumor of the endometrium in a post-menopausal woman: Case report and review of the literature","volume":"36","author":"Sinha","year":"2021","journal-title":"Gynecol Oncol Rep"},{"key":"2026020406551400000_19.2.e269276.3","article-title":"Germ Cell Tumor of the Yolk Sac in the Uterine Corpus: Case Report of a 14-Month-Old Female Infant","volume":"15","author":"Su\u00e1rez","year":"2023","journal-title":"Cureus"},{"key":"2026020406551400000_19.2.e269276.4","doi-asserted-by":"crossref","DOI":"10.1177\/2050313X211027734","article-title":"Pure primary yolk sac tumor of the endometrium tends to occur at a younger age: A case report and literature analysis","volume":"9","author":"Ge","year":"2021","journal-title":"SAGE Open Med Case Rep"},{"key":"2026020406551400000_19.2.e269276.5","doi-asserted-by":"crossref","first-page":"928234","DOI":"10.3389\/fonc.2022.928234","article-title":"Relapsed and refractory yolk sac tumor of the peritoneum (mesentery): A case report and literature review","volume":"12","author":"Zhou","year":"2022","journal-title":"Front Oncol"},{"key":"2026020406551400000_19.2.e269276.6","doi-asserted-by":"crossref","DOI":"10.1016\/j.gore.2022.101038","article-title":"Yolk sac tumor presenting as a colonic mass in a post-menopausal woman: A case report","volume":"42","author":"Short","year":"2022","journal-title":"Gynecol Oncol Rep"},{"key":"2026020406551400000_19.2.e269276.7","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181ad25d5"},{"key":"2026020406551400000_19.2.e269276.8","doi-asserted-by":"crossref","first-page":"110","DOI":"10.6001\/actamedica.v23i2.3327","article-title":"Successful treatment of advanced stage yolk sac tumour of extragonadal origin: a case report and review of literature","volume":"23","author":"Rudaitis","year":"2016","journal-title":"AML"},{"key":"2026020406551400000_19.2.e269276.9","doi-asserted-by":"crossref","unstructured":"Ali-Fehmi R , Kheil M , Almohsen NA , et al . TNM\/Figo classification, pathology of the uterine corpus. Cham: Springer, 2023:595\u2013600.","DOI":"10.1007\/978-3-030-97378-0_5623"},{"key":"2026020406551400000_19.2.e269276.10","doi-asserted-by":"crossref","unstructured":"Abd Almohsen N . WHO classification of tumours of the uterine corpus, pathology of the uterine corpus. Springer, Cham, 2023:655\u20136.","DOI":"10.1007\/978-3-030-97378-0_5622"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T14:55:54Z","timestamp":1770216954000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":10,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,4]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bcr-2025-269276"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269276","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}