Document Detail

Ovarian yolk sac tumor with virilization during pregnancy: immunohistochemical demonstration of Leydig cells as functioning stroma.
MedLine Citation:
PMID:  10886732     Owner:  NLM     Status:  MEDLINE    
A case is reported of yolk sac tumor occurring in the left ovary and complicated by pregnancy. The 22-year-old patient presented at 28 weeks gestation with virilization and elevated serum levels of testosterone and alpha-fetoprotein. The tumor showed the typical features of yolk sac tumor with a mixture of islands of Leydig cells. The accumulations of Leydig cells were well demarcated from the cellular components of the yolk sac tumor and were distributed throughout the tumor, although with predominant localization at the periphery. By immunohistochemistry the Leydig cells were intensely positive for vimentin and negative for cytokeratins, allowing clear distinction from the cell components of the yolk sac tumor, which were positive for cytokeratins and negative for vimentin. Testosterone was also identified in the cytoplasm of the Leydig cells. After tumor resection the testosterone and alpha-fetoprotein levels declined simultaneously; this, together with the immunohistochemical demonstration of testosterone, indicates that the Leydig cells were responsible for the endocrine manifestations. Furthermore, antibodies against inhibin alpha-subunit and calretinin could be used to detect the Leydig cells. The present case, a combination of yolk sac tumor and Leydig cells acting as a functioning stroma and causing virilization during pregnancy, is very rare.
N Arima; A Tanimoto; R Hayashi; T Hamada; Y Sasaguri
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pathology international     Volume:  50     ISSN:  1320-5463     ISO Abbreviation:  Pathol. Int.     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-09-08     Completed Date:  2000-09-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9431380     Medline TA:  Pathol Int     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  520-5     Citation Subset:  IM    
Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health and Department of Obstetrics and Gynecology, National Kokura Hospital, Kitakyushu, Japan.
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MeSH Terms
Endodermal Sinus Tumor / metabolism,  pathology*
Keratins / analysis
Leydig Cells / chemistry,  pathology
Ovarian Neoplasms / metabolism,  pathology*
Pregnancy Complications*
Stromal Cells / pathology
Testosterone / analysis,  blood
Virilism / blood,  pathology*
alpha-Fetoproteins / analysis
Reg. No./Substance:
0/alpha-Fetoproteins; 58-22-0/Testosterone; 68238-35-7/Keratins

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