Human pathology · 2025
Somatic yolk sac tumors in the urinary tract: A form of rare divergent differentiation.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Tedrow Nicholas, Ogan Kenneth, Joshi Shreyas, Bilen Mehmet Asim, Brown Jacqueline, Carthon Bradley, Saeed Faisal, Gandhi Jatin, Genega Elizabeth, Harik Lara
Аннотация
CONTEXT: Yolk sac tumor (YST) is a germ cell tumor, arising commonly from the gonads and rarely from other midline sites. Somatic Yolk sac tumors, arising from somatic malignancy, have been rarely reported in the gastrointestinal tract, gynecologic tract, and recently, in the urinary tract.
OBJECTIVE: We share our institutional experience of somatic YST arising from the urothelium.
DESIGN: Electronic medical records (EMR) were searched for cases of somatic YST differentiation in the urinary tract. Clinico-pathologic parameters were collected and reviewed, including clinical presentation, histologic and immunohistochemical findings, follow-up status, and duration.
RESULTS: EMR search identified 4 cases of somatic yolk sac tumor arising from the urothelial tract. In 3 of 4 patients, the YST component was admixed with urothelial carcinoma. Histologic features of somatic YST included glandular differentiation with clearing of the cytoplasm. Papillary/pseudopapillary and solid components were also present. An immunohistochemical panel including AFP, Glypican 3 and SALL4 is helpful in confirming this rare form of divergent differentiation. Two cases presented de novo, one of them showed a pedunculated urethral mass composed of pure somatic YST; i12p on this case was negative.
CONCLUSIONS: Somatic YST differentiation in the urinary tract is a rare occurrence with potential for treatment implications. Familiarity with the histologic features is key to diagnosing this rare form of divergent differentiation. Molecular events leading to the development of somatic YST and optimal therapy remain unclear.
OBJECTIVE: We share our institutional experience of somatic YST arising from the urothelium.
DESIGN: Electronic medical records (EMR) were searched for cases of somatic YST differentiation in the urinary tract. Clinico-pathologic parameters were collected and reviewed, including clinical presentation, histologic and immunohistochemical findings, follow-up status, and duration.
RESULTS: EMR search identified 4 cases of somatic yolk sac tumor arising from the urothelial tract. In 3 of 4 patients, the YST component was admixed with urothelial carcinoma. Histologic features of somatic YST included glandular differentiation with clearing of the cytoplasm. Papillary/pseudopapillary and solid components were also present. An immunohistochemical panel including AFP, Glypican 3 and SALL4 is helpful in confirming this rare form of divergent differentiation. Two cases presented de novo, one of them showed a pedunculated urethral mass composed of pure somatic YST; i12p on this case was negative.
CONCLUSIONS: Somatic YST differentiation in the urinary tract is a rare occurrence with potential for treatment implications. Familiarity with the histologic features is key to diagnosing this rare form of divergent differentiation. Molecular events leading to the development of somatic YST and optimal therapy remain unclear.