Yolk sac tumor (YST) is a germ cell neoplasm that arises predominantly in the gonads, but can also\nderive from somatic neoplasms in extragonadal locations. These latter cases have been documented in several\norgans, although reports from the urinary tract are limited. To our knowledge, this is the first report of a bladder\nurothelial carcinoma with a predominant component of YST differentiation.\nCase presentation: We present a unique case of a 76-year-old man with a recurrent urinary bladder tumor, initially\ninterpreted as a high grade urothelial carcinoma with glandular differentiation. In the recurrent tumor, diverse\nhistological patterns were identified, including glandular, hepatoid and sarcomatoid. This tumor showed positivity\nfor AFP, GLP3 and SALL4, and negativity for CK7 and EMA. Fluorescent in situ hybridization study showed a\npolysomic pattern of chromosome 12. All these findings led to the final diagnosis of a YST derived from urothelial\ncarcinoma.\nConclusions: YST differentiation should be considered in the differential diagnosis of a high grade urothelial\ncarcinoma, particularly when glandular and other unusual patterns are observed.
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