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High grade serous carcinoma is the most common ovarian epithelial malignancy.1 Ovarian yolk sac tumours (YST) are much more uncommon and are morphologically heterogeneous, primitive teratoid neoplasms differentiating into multiple endodermal structures.2 They almost always occur before age 30 and are extremely rare in perimenopausal and postmenopausal women. Rare examples have been reported in elderly patients, sometimes associated with an ovarian surface epithelial-stromal tumour, most commonly endometrioid adenocarcinoma but occasionally carcinosarcoma, clear cell carcinoma or a mucinous neoplasm; rarely the epithelial component is benign.3–13 In a review of the literature, we have identified 18 ovarian neoplasms exhibiting a combination of YST and a surface epithelial-stromal tumour.3–13 The combination of endometrioid adenocarcinoma and YST should be distinguished from YST with endometrioid-like glands (‘pseudoendometrioid’ YST).
We describe an unusual and extremely rare ovarian neoplasm with components of high grade serous carcinoma and YST in a 69-year-old postmenopausal woman. As far as we are …