PMID- 34255554 OWN - NLM STAT- MEDLINE DCOM- 20220308 LR - 20220308 IS - 1940-2465 (Electronic) IS - 1066-8969 (Linking) VI - 30 IP - 2 DP - 2022 Apr TI - Somatic-Type Yolk Sac Tumor Arising as a Predominant Component of Bladder Urothelial Carcinoma. PG - 207-213 LID - 10.1177/10668969211030688 [doi] AB - Germ cell differentiation has been described in association with somatic tumors arising from several organ systems; rare cases arising from urothelium have been reported. Here we present a 62-year-old male with a remote history of lung cancer, a left adrenal gland mass, and a 5.6 cm left bladder wall mass; cystoscopy demonstrated a large papillary mass on the left anterior bladder wall. A transurethral resection specimen was sent for review in consultation and showed extensive papillary structures with thin fibrovascular cores lined by neoplastic cells with clear cytoplasm. These neoplastic cells were diffusely positive for pancytokeratin, CDX2 (caudal-type homebox 2), SALL4 (sal-like transcription factor 4), glypican-3, AFP (alpha-fetoprotein), while negative for PAX-8 (paired box gene 8), NKX3.1 (NK3 homeobox 1), PSA (prostate specific antigen), TTF-1 (thyroid transcription factor 1), Napsin A, inhibin, and OCT4 (octamer-binding transcription factor 4). Conventional urothelial conventional carcinoma and focal squamous differentiation were also identified as minor components. Urothelial carcinoma was focally positive for GATA3 (GATA-binding protein 3) and p63; SALL4 and glypican-3 were negative. Overall findings supported a yolk sac tumor with a smaller component of squamous cell carcinoma (<1%). Subsequent cystectomy showed similar morphologic features and immunoprofile in addition to foci of urothelial carcinoma and urothelial carcinoma in situ. No chromosome 12p abnormalities were identified by fluorescent in-situ hybridization study. A diagnosis of yolk sac tumor derived from urothelial carcinoma was made. Yolk sac tumor should be considered in the differential diagnosis of a high-grade urothelial carcinoma, particularly when glandular or other unusual architectural patterns are present. A somatic origin with underlying genomic instability similar to what has been described in the uterus and ovaries is suggested. FAU - Collins, Katrina AU - Collins K AUID- ORCID: 0000-0002-9603-6731 AD - 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA. FAU - Alkashash, Ahmad M AU - Alkashash AM AD - 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA. FAU - Hwang, Michael AU - Hwang M AD - 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA. FAU - Kaimakliotis, Hristos Z AU - Kaimakliotis HZ AD - 12250Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA. FAU - Cheng, Liang AU - Cheng L AD - 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA. FAU - Idrees, Muhammad T AU - Idrees MT AUID- ORCID: 0000-0001-6611-6389 AD - 12250Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA. LA - eng PT - Case Reports PT - Journal Article DEP - 20210713 PL - United States TA - Int J Surg Pathol JT - International journal of surgical pathology JID - 9314927 RN - 0 (Biomarkers, Tumor) SB - IM MH - Biomarkers, Tumor MH - *Carcinoma, Transitional Cell/diagnosis/pathology MH - *Endodermal Sinus Tumor/diagnosis/pathology MH - Female MH - Humans MH - Male MH - Middle Aged MH - Urinary Bladder/pathology MH - *Urinary Bladder Neoplasms/pathology MH - Urothelium/pathology OTO - NOTNLM OT - case report OT - fluorescence in-situ hybridization OT - immunohistochemistry OT - urothelial carcinoma OT - yolk sac tumor differentiation EDAT- 2021/07/14 06:00 MHDA- 2022/03/09 06:00 CRDT- 2021/07/13 17:14 PHST- 2021/07/14 06:00 [pubmed] PHST- 2022/03/09 06:00 [medline] PHST- 2021/07/13 17:14 [entrez] AID - 10.1177/10668969211030688 [doi] PST - ppublish SO - Int J Surg Pathol. 2022 Apr;30(2):207-213. doi: 10.1177/10668969211030688. Epub 2021 Jul 13.