A case report of gastroesophageal adenocarcinoma with yolk sac tumor differentiation in a pregnant patient.

Publication/Presentation Date

4-30-2026

Abstract

BACKGROUND: Gastroesophageal adenocarcinomas with yolk sac tumor (YST) differentiation is an exceptionally rare and aggressive malignancy with only a limited number of cases described in the literature. YSTs are typically gonadal in origin with only a small percentage presenting in extragonadal sites. Somatic tumors, such as gastroesophageal adenocarcinoma, that have YST differentiation remain poorly understood. To our knowledge, such a presentation in the context of pregnancy has not been previously documented, making this case uniquely challenging in terms of diagnosis, management, and prognosis.

CASE DESCRIPTION: We report the case of a 22-year-old gravida 1 para 0 female at 29 weeks gestation who presented with gastrointestinal bleeding and right upper quadrant pain. Imaging revealed hepatic, pancreatic, and multiple pulmonary metastases. The liver biopsy initially suggested high-grade neuroendocrine carcinoma, but subsequent pathology review confirmed adenocarcinoma with YST differentiation originating at the gastroesophageal junction. The patient underwent emergent Cesarean section followed by sequential cytotoxic anticancer treatments with short lived responses during and after each regimen. The patient died 18 months after initial presentation.

CONCLUSIONS: This case underscores the diagnostic complexity and therapeutic challenges of gastroesophageal adenocarcinomas with YST differentiation, especially in young patients. It highlights the importance of expert specialized pathology review, multidisciplinary care, and further research into effective treatment strategies for this rare entity.

Volume

17

Issue

2

First Page

103

Last Page

103

ISSN

2078-6891

Disciplines

Medicine and Health Sciences

PubMedID

42169898

Department(s)

Department of Medicine, Hematology-Medical Oncology Division, Hematology-Medical Oncology Division Fellows and Residents, Fellows and Residents

Document Type

Article

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