Pediatric Vaginal Yolk Sac Tumor: Reappraisal of Treatment Strategy in a Rare Tumor at a Unique Location

J Pediatr Hematol Oncol. 2015 Jul;37(5):391-5. doi: 10.1097/MPH.0000000000000344.


Review of the management of 6 young girls with vaginal yolk sac tumor over 25 years showed that the α-fetoprotein levels normalized in 5/6 within 4 cycles of primary cisplatin, bleomycin, etoposide (PEB)/carboplatin, etoposide, bleomycin (JEB)/cisplatin, vinblastine, bleomycin (PVB) chemotherapy. Radioimaging revealed residual tissue but viable tumor was found in only 1 of 2 biopsied. Resection/biopsy is necessary to avoid giving additional primary chemotherapy or to identify patients who need different treatment. If markers do not decay appropriately, PEB/JEB/PVB chemotherapy should not be continued. Taxol-containing salvage chemotherapy regimens, adjuvant modern radiotherapeutic treatment, and fertility-saving curative surgery should then be considered. Despite having mostly advanced disease, 5/6 patients were cured, 2 with chemotherapy alone.

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brachytherapy
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Endodermal Sinus Tumor / pathology*
  • Endodermal Sinus Tumor / therapy*
  • Female
  • Follow-Up Studies
  • Gynecologic Surgical Procedures
  • Humans
  • Infant
  • Treatment Outcome
  • Vaginal Neoplasms / pathology*
  • Vaginal Neoplasms / therapy*
  • Young Adult