{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T18:04:25Z","timestamp":1775585065027,"version":"3.50.1"},"reference-count":72,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2]]},"abstract":"Extragonadal germ cell tumors are uncommon, and although they morphologically resemble their gonadal counterparts, unexpected gonadal presentation increases the potential for erroneous diagnoses. Yolk sac tumor is a malignant germ cell tumor characterized by an extraembryonic yolk sac line of differentiation, and relative to other germ cell tumors, is characterized by varied and diverse histologic patterns. When occurring outside of typical age parameters or in extragonadal locations, the histologic variability of yolk sac tumor and its tendency to mimic somatic tumors pose diagnostic challenges. Because extragonadal yolk sac tumor of the vulva is very rare, with only isolated case reports and small series in the literature, it is often not considered in the differential diagnosis. As both prognosis and management of yolk sac tumor differ significantly from those of somatic tumors, accurate diagnosis is essential. This review discusses histologic features of extragonadal yolk sac tumor, addresses somatic tumors arising in the vulva for which yolk sac tumor may be confused, and provides guidance with respect to the use of immunohistochemistry in the diagnosis of yolk sac tumor.<\/jats:p>","DOI":"10.5858\/arpa.2016-0151-sa","type":"journal-article","created":{"date-parts":[[2016,12,13]],"date-time":"2016-12-13T16:29:55Z","timestamp":1481646595000},"page":"293-297","source":"Crossref","is-referenced-by-count":20,"title":["Unusual Presentations of Gynecologic Tumors: Extragonadal Yolk Sac Tumor of the Vulva"],"prefix":"10.5858","volume":"141","author":[{"given":"Elizabeth D.","family":"Euscher","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"issue":"7","key":"i1543-2165-141-2-293-b01","series-title":"Histopathology","first-page":"1023","article-title":"Yolk sac tumours revisited: a review of their many faces and names","volume":"60","author":"Nogales \n FF,","year":"2012","unstructured":"Nogales \n FF, \n \n \n Preda \n O, \n \n \n Nicolae \n A. \n \n \n Yolk sac tumours revisited: a review of their many faces and names. 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Histopathology. 2014;65(1):51\u201359."},{"issue":"2","key":"i1543-2165-141-2-293-b03","series-title":"Adv Anat Pathol","first-page":"69","article-title":"Extragonadal germ cell tumors: a review with emphasis on pathologic features, clinical prognostic variables, and differential diagnostic considerations","volume":"14","author":"McKenney \n JK,","year":"2007","unstructured":"McKenney \n JK, \n \n \n Heerema-McKenney \n A, \n \n \n Rouse \n RV. \n \n \n Extragonadal germ cell tumors: a review with emphasis on pathologic features, clinical prognostic variables, and differential diagnostic considerations. Adv Anat Pathol. 2007;14(2):69\u201392."},{"issue":"3","key":"i1543-2165-141-2-293-b04","series-title":"Cancer","first-page":"620","article-title":"Extraovarian pelvic yolk sac tumors","volume":"62","author":"Clement \n PB,","year":"1988","unstructured":"Clement \n PB, \n \n \n Young \n RH, \n \n \n Scully \n RE. \n \n \n Extraovarian pelvic yolk sac tumors. 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Case Rep Oncol. 2012;5(3):671\u2013675."},{"issue":"6","key":"i1543-2165-141-2-293-b11","series-title":"Obstet Gynecol Sci","first-page":"412","article-title":"Primary omental yolk sac tumor","volume":"56","author":"Lim \n SH,","year":"2013","unstructured":"Lim \n SH, \n \n \n Kim \n YH, \n \n \n Yim \n GW, \n \n et al. \n Primary omental yolk sac tumor. Obstet Gynecol Sci. 2013;56(6):412\u2013415."},{"issue":"4","key":"i1543-2165-141-2-293-b12","series-title":"Korean J Radiol","first-page":"472","article-title":"Primary yolk sac tumor arising in the pancreas with hepatic metastasis: a case report","volume":"11","author":"Zhang \n B,","year":"2010","unstructured":"Zhang \n B, \n \n \n Gao \n S, \n \n \n Chen \n Y, \n \n et al. \n Primary yolk sac tumor arising in the pancreas with hepatic metastasis: a case report. 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Oncol Lett. 2014;7(1):199\u2013202."},{"issue":"1","key":"i1543-2165-141-2-293-b15","series-title":"Gynecol Oncol","first-page":"368","article-title":"Primary yolk sac tumor concomitant with carcinosarcoma originating from the endometrium: case report","volume":"103","author":"Oguri \n H,","year":"2006","unstructured":"Oguri \n H, \n \n \n Sumitomo \n R, \n \n \n Maeda \n N, \n \n et al. \n Primary yolk sac tumor concomitant with carcinosarcoma originating from the endometrium: case report. Gynecol Oncol. 2006;103(1):368\u2013371."},{"issue":"4","key":"i1543-2165-141-2-293-b16","series-title":"Am J Obstet Gynecol","first-page":"e3","article-title":"Primary yolk sac tumor of the endometrium: a case report and review of the literature","volume":"204","author":"Rossi \n R,","year":"2011","unstructured":"Rossi \n R, \n \n \n Stacchiotti \n D, \n \n \n Garzia Beranardini \n M, \n \n et al. \n Primary yolk sac tumor of the endometrium: a case report and review of the literature. Am J Obstet Gynecol. 2011;204(4):e3\u2013e4."},{"issue":"2","key":"i1543-2165-141-2-293-b17","series-title":"Gynecol Oncol","first-page":"285","article-title":"Primary yolk sac tumor of the endometrium: a case report and review of the literature","volume":"70","author":"Spatz \n A,","year":"1998","unstructured":"Spatz \n A, \n \n \n Bouron \n D, \n \n \n Pautier \n P, \n \n et al. \n Primary yolk sac tumor of the endometrium: a case report and review of the literature. Gynecol Oncol. 1998;70(2):285\u2013288."},{"issue":"4","key":"i1543-2165-141-2-293-b18","series-title":"Cancer","first-page":"1627","article-title":"Endodermal sinus tumor: the Stanford experience and the first reported case arising in the vulva","volume":"41","author":"Ungerleider \n RS,","year":"1978","unstructured":"Ungerleider \n RS, \n \n \n Donaldson \n SS, \n \n \n Warnke \n RA, \n \n et al. \n Endodermal sinus tumor: the Stanford experience and the first reported case arising in the vulva. Cancer. 1978;41(4):1627\u20131634."},{"issue":"3","key":"i1543-2165-141-2-293-b19","series-title":"Gynecol Oncol","first-page":"376","article-title":"Endodermal sinus tumor of the clitoris","volume":"9","author":"Castaldo \n TW,","year":"1980","unstructured":"Castaldo \n TW, \n \n \n Petrilli \n ES, \n \n \n Ballon \n SC, \n \n et al. \n Endodermal sinus tumor of the clitoris. Gynecol Oncol. 1980;9(3):376\u2013380."},{"issue":"3","key":"i1543-2165-141-2-293-b20","series-title":"Gynecol Oncol","first-page":"379","article-title":"Endodermal sinus (yolk sac) tumor of the vulva in a pregnant female","volume":"11","author":"Krishnamurthy \n SC,","year":"1981","unstructured":"Krishnamurthy \n SC, \n \n \n Sampat \n MB. \n \n \n Endodermal sinus (yolk sac) tumor of the vulva in a pregnant female. 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Gynecol Oncol. 1997;66(3):515\u2013518."},{"issue":"5","key":"i1543-2165-141-2-293-b25","series-title":"Int J Gynecol Cancer","first-page":"998","article-title":"Endodermal sinus tumor of the vulva: successfully treated with high-dose chemotherapy","volume":"14","author":"Traen \n K,","year":"2004","unstructured":"Traen \n K, \n \n \n Logghe \n H, \n \n \n Maertens \n J, \n \n et al. \n Endodermal sinus tumor of the vulva: successfully treated with high-dose chemotherapy. Int J Gynecol Cancer. 2004;14(5):998\u20131003."},{"issue":"4","key":"i1543-2165-141-2-293-b26","series-title":"Eur J Gynaecol Oncol","first-page":"395","article-title":"Primary yolk sac tumor (endodermal sinus tumor) of the vulva: case report and review of the literature","volume":"27","author":"Basgul \n A,","year":"2006","unstructured":"Basgul \n A, \n \n \n Gokaslan \n H, \n \n \n Kavak \n ZN, \n \n et al. \n Primary yolk sac tumor (endodermal sinus tumor) of the vulva: case report and review of the literature. Eur J Gynaecol Oncol. 2006;27(4):395\u2013398."},{"issue":"6","key":"i1543-2165-141-2-293-b27","series-title":"Eur J Gynaecol Oncol","first-page":"506","article-title":"Primary endodermal sinus tumor of the vulva in a 52-year-old woman with long-term survival: a case report","volume":"28","author":"Niwa \n K,","year":"2007","unstructured":"Niwa \n K, \n \n \n Onogi \n K, \n \n \n Wu \n Y, \n \n et al. \n Primary endodermal sinus tumor of the vulva in a 52-year-old woman with long-term survival: a case report. Eur J Gynaecol Oncol. 2007;28(6):506\u2013508."},{"issue":"1","key":"i1543-2165-141-2-293-b28","series-title":"Med Princ Pract","first-page":"90","article-title":"Primary yolk sac (endodermal sinus) tumour of the vulva: a case report","volume":"20","author":"Subrahmanya \n NB,","year":"2011","unstructured":"Subrahmanya \n NB, \n \n \n Kapadi \n SN, \n \n \n Junaid \n TA. \n \n \n Primary yolk sac (endodermal sinus) tumour of the vulva: a case report. 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Am J Surg Pathol. 2009;33(6):894\u2013904."},{"issue":"10","key":"i1543-2165-141-2-293-b33","series-title":"Am J Surg Pathol","first-page":"1529","article-title":"Diagnostic utility of SALL4 in extragonadal yolk sac tumors","volume":"33","author":"Wang \n F,","year":"2009","unstructured":"Wang \n F, \n \n \n Liu \n A, \n \n \n Peng \n Y, \n \n et al. \n Diagnostic utility of SALL4 in extragonadal yolk sac tumors. Am J Surg Pathol. 2009;33(10):1529\u20131539."},{"issue":"1","key":"i1543-2165-141-2-293-b34","series-title":"Histopathology","first-page":"71","article-title":"A practical approach to immunohistochemical diagnosis of ovarian germ cell tumours and sex cord-stromal tumours","volume":"62","author":"Rabban \n JT,","year":"2013","unstructured":"Rabban \n JT, \n \n \n Zaloudek \n CJ. \n \n \n A practical approach to immunohistochemical diagnosis of ovarian germ cell tumours and sex cord-stromal tumours. Histopathology. 2013;62(1):71\u201388."},{"issue":"6","key":"i1543-2165-141-2-293-b35","series-title":"Mod Pathol","first-page":"824","article-title":"Glypican-3 expression in clear cell adenocarcinoma of the ovary","volume":"22","author":"Maeda \n D,","year":"2009","unstructured":"Maeda \n D, \n \n \n Ota \n S, \n \n \n Takazawa \n Y, \n \n et al. \n Glypican-3 expression in clear cell adenocarcinoma of the ovary. Mod Pathol. 2009;22(6):824\u2013832."},{"issue":"11","key":"i1543-2165-141-2-293-b36","series-title":"Am J Surg Pathol","first-page":"1499","article-title":"The use of cytokeratin 7 and EMA in differentiating ovarian yolk sac tumors from endometrioid and clear cell carcinomas","volume":"28","author":"Ramalingam \n P,","year":"2004","unstructured":"Ramalingam \n P, \n \n \n Malpica \n A, \n \n \n Silva \n EG, \n \n et al. \n The use of cytokeratin 7 and EMA in differentiating ovarian yolk sac tumors from endometrioid and clear cell carcinomas. 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Histopathology. 2014;65(1):51\u201359."},{"issue":"2","key":"i1543-2165-141-2-293-b03","series-title":"Adv Anat Pathol","first-page":"69","article-title":"Extragonadal germ cell tumors: a review with emphasis on pathologic features, clinical prognostic variables, and differential diagnostic considerations","volume":"14","author":"McKenney \n JK,","year":"2007","unstructured":"McKenney \n JK, \n \n \n Heerema-McKenney \n A, \n \n \n Rouse \n RV. \n \n \n Extragonadal germ cell tumors: a review with emphasis on pathologic features, clinical prognostic variables, and differential diagnostic considerations. Adv Anat Pathol. 2007;14(2):69\u201392."},{"issue":"3","key":"i1543-2165-141-2-293-b04","series-title":"Cancer","first-page":"620","article-title":"Extraovarian pelvic yolk sac tumors","volume":"62","author":"Clement \n PB,","year":"1988","unstructured":"Clement \n PB, \n \n \n Young \n RH, \n \n \n Scully \n RE. \n \n \n Extraovarian pelvic yolk sac tumors. 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