A rare clinical case of delivery of a patient after surgical treatment of ovarian yolk sac tumor

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Abstract

Background: Yolk sac tumors account for 10–20% of all malignant germ cell tumors of the ovary. They are more common in children, adolescents and young women, and are classified as aggressive, fast-growing tumors. They have the least favorable prognosis of all germ cell tumors. The combination of surgical treatment with adjuvant chemotherapy involving platinum preparations has been shown to achieve positive results, with 5-year overall survival rates ranging from 80 to 95%, depending on the stage of the tumor process. The modern approach to treatment makes it possible to predict a favorable outcome in yolk sac tumor in terms of preserving not only life but also the girl’s reproductive function.

Case report: This is a clinical case study of a caesarean section performed on a 20-year-old female patient who underwent surgery at the age of 15 for an ovarian yolk sac tumor, ascites and implantation metastasis of the anterior abdominal wall. The patient received five courses of chemotherapeutic treatment based on cisplatin, etoposide and ifosfamide (PEI). The subsequent course started on day 22 from the beginning of the previous course, provided that the neutrophil count was above 500/μL and the platelet count was above 80,000/μL.

After the 4 courses of chemotherapy, she underwent Pfannenstiel laparotomy, removal of the affected ovary, implantation metastasis, and exploration of the abdominal cavity. The postoperative period proceeded without complications, and the 5th course of chemotherapy was subsequently performed. Rehabilitation was successful due to the teamwork of obstetricians, oncologists, chemotherapists and psychologists. Psychological support was provided during the entire chemotherapy period.

Conclusion: The modern level of medical science with timely diagnosis and adequate treatment of yolk sac tumor provides a favorable prognosis in preserving life and reproductive function of a girl. Clinical observation could benefit obstetricians, as well as pediatric gynecologists, oncologists and pediatric surgeons.

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About the authors

Lyudmila V. Renge

Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; G.P. Kurbatov Novokuznetsk City Clinical Hospital

Author for correspondence.
Email: l.renge@mail.ru
ORCID iD: 0000-0002-7237-9721

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Novokuznetsk State Institute for Further Training of Physicians – Branch of the Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia

Russian Federation, 5, Stroiteley Ave., Novokuznetsk, 654005; Novokuznetsk

Ekaterina Yu. Grigorieva

Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; G.P. Kurbatov Novokuznetsk City Clinical Hospital

Email: prutovykh@icloud.com
ORCID iD: 0000-0002-8623-729X

PhD, Associate Professor, Department of Obstetrics and Gynecology, Novokuznetsk State Institute for Further Training of Physicians – Branch of the Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia

Russian Federation, 5, Stroiteley Ave., Novokuznetsk, 654005; Novokuznetsk

Natalia A. Samusenko

G.P. Kurbatov Novokuznetsk City Clinical Hospital

Email: l.renge@mail.ru

obstetrician-gynecologist

Russian Federation, Novokuznetsk

Vladimir G. Levchenko

Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; G.P. Kurbatov Novokuznetsk City Clinical Hospital

Email: vglev@ya.ru
ORCID iD: 0000-0002-2809-0568

PhD, Associate Professor, Department of Obstetrics and Gynecology, Novokuznetsk State Institute for Further Training of Physicians – Branch of the Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia

Russian Federation, 5, Stroiteley Ave., Novokuznetsk, 654005; Novokuznetsk

Victoria V. Likhacheva

Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia

Email: viroli@mail.ru
ORCID iD: 0000-0002-5637-7590

Dr. Med. Sci., Associate Professor, Professor, Department of Obstetrics and Gynecology, Novokuznetsk State Institute for Further Training of Physicians

Russian Federation, 5, Stroiteley Ave., Novokuznetsk, 654005

Svetlana V. Shramko

Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia

Email: shramko_08@mail.ru
ORCID iD: 0000-0003-1299-165X

Dr. Med. Sci., Associate Professor, Professor, Department of Obstetrics and Gynecology, Novokuznetsk State Institute for Further Training of Physicians

Russian Federation, 5, Stroiteley Ave., Novokuznetsk, 654005

Boris A. Likhachev

Kemerovo State University

Email: viroli@mail.ru

PhD Student at the Department of Genetics and Fundamental Medicine

Russian Federation, 73 bld. 2, Sovetsky Ave., Kemerovo, 650043

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