OVARIAN YOLK SAC TUMOR COMPLICATING PREGNANCY - A CASE REPORT

Malignant ovarian germ cell tumor (MOGCT) is a very rare malignancy in young pregnant women. We present a case report of a 20 year- old woman, with history of two and a half months amenorrhea and complaints of abdominal distention and respiratory difficulty for 2 weeks. She was dyspneic with poor performance status. Clinical examination revealed huge abdominal distention due to ascitis and a pelvic mass up to umbilicus. Ultrasound showed 25-20-18 centimeters solid and cystic mass in pelvis, gross ascitis and an intrauterine gestational sac of 10 weeks gestation. Malignant cells in ascitic fluid cytology and abnormally high serum alpha fetoprotein levels (AFP) suggested the diagnosis of yolk sac tumor (YST) of the ovary. Because of the advanced disease, two cycles of neoadjuvant chemotherapy with BEP regimen was given before conservative surgery.In case of early pregnancy with advanced yolk sac tumors, neoadjuvant chemotherapy can be given to downstage the disease, followed by definitive fertility sparing staging procedures.