Schiller Duval Bodies · What Are They, Causes, and More

A Schiller Duval body is a cellular structure that is characterized by the presence of a central blood vessel surrounded by layers of tumor cells. Schiller Duval bodies are most commonly found in testicular yolk sac tumors. In fact, if identified under a microscope, Schiller Duval bodies are pathognomonic, meaning that they can confirm a diagnosis of yolk sac tumors.

Schiller Duval bodies were first described by Walter Schiller, an American pathologist, and Mathias-Marie Duval, a French professor of anatomy and histology.

Yolk sac tumors are the most common cause of Schiller Duval bodies. Also known as endodermal sinus tumors, yolk sac tumors are malignant germ cell tumors, meaning that these tumors are aggressive, or will spread, and form in the cells that typically become the reproductive cells (i.e., eggs, sperm). Germ cell tumors are usually found in the gonads (i.e., testicles, ovaries) of children. However, they may sometimes present in other locations of the body, such as the brain or the mediastinum, which is the compartment between the lungs.

Yolk sac tumors have similar cellular structures to the yolk sac, which is the first source of nourishment for the developing fetus. They present with various common derivatives of the germ layers: the endoderm, mesoderm, and ectoderm. For example, in both the yolk sac and yolk sac tumors, part of the primitive gut (coming from the endoderm) or mesenchyme (coming from the mesoderm) can be identified.

Yolk sac tumors are most commonly found in the pediatric age group. In fact, they are the most common type of testicular cancer found in young children under the age of 3. Yolk sac tumors are likely to cause illness and death if not diagnosed and treated quickly. 

The optimal treatment for yolk sac tumors is chemotherapy followed by surgical removal of the mass.

In most cases, especially those in which the cancerous cells have spread from their area of origin into other locations in the body, called metastasis, or where germ cell tumors are recurrent, chemotherapy is recommended before surgical excision of the mass. Chemotherapy is used to inhibit the growth of the rapidly dividing cancerous cells and consequently minimize the tumor’s size.

Following chemotherapy, and in addition to surgical removal of the tumor, surgical excision of one or both testicles (i.e., orchiectomy) or of one or both ovaries (i.e., oophorectomy) is typically indicated, as well as additional removal of any affected lymph nodes.

Despite the available treatment options, prognosis remains poor for yolk sac tumors. 

Schiller Duval bodies refer to histologic structures that are characterized by the presence of a central blood vessel and lined by flattened layers of tumor cells and fibrous tissue. They are most commonly present in yolk sac tumors, either of the testicles or the ovaries, but they may also be found in non-gonadal sites. Treatment typically requires chemotherapy and surgical excision of the tumors.