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Chang JYC, Woo CSL, Chow WS, White A, Wong KC, Tsui P, Lee ACH, Leung EKH, Woo YC, Tan KCB, Lam KSL, Lee CH, Lui DTW. Cushing's syndrome caused by ACTH precursors secreted from a pancreatic yolk sac tumor in an adult-a case report and literature review. Front Med (Lausanne) 2023; 10:1246796. [PMID: 38116038 PMCID: PMC10728467 DOI: 10.3389/fmed.2023.1246796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Here, we report the first adult case of pancreatic yolk sac tumor with ectopic adrenocorticotropic hormone (ACTH) syndrome. The patient was a 27-year-old woman presenting with abdominal distension, Cushingoid features, and hyperpigmentation. Endogenous Cushing's syndrome was biochemically confirmed. The ACTH level was in the normal range, which raised the suspicion of ACTH precursor-dependent disease. Elevated ACTH precursors were detected, supporting the diagnosis of ectopic ACTH syndrome. Functional imaging followed by tissue sampling revealed a pancreatic yolk sac tumor. The final diagnosis was Cushing's syndrome due to a yolk sac tumor. The patient received a steroidogenesis inhibitor and subsequent bilateral adrenalectomy for control of hypercortisolism. Her yolk sac tumor was treated with chemotherapy and targeted therapy. Cushing's syndrome secondary to a yolk sac tumor is extremely rare. This case illustrated the utility of ACTH precursor measurement in confirming an ACTH-related pathology and distinguishing an ectopic from a pituitary source for Cushing's syndrome.
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Affiliation(s)
- Johnny Yau Cheung Chang
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Chariene Shao Lin Woo
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Wing Sun Chow
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Anne White
- School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Ka Chung Wong
- Department of Pathology, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
| | - Po Tsui
- Department of Pathology, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China
| | - Alan Chun Hong Lee
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Eunice Ka Hong Leung
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Yu Cho Woo
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Kathryn Choon Beng Tan
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Karen Siu Ling Lam
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Chi Ho Lee
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - David Tak Wai Lui
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Zahid MJ, Hussain M, Zeb M, Haseeb A, Khan HB. Endodermal sinus tumor with pancreatic origin: A case report. Int J Surg Case Rep 2022; 101:107783. [PMID: 36413894 PMCID: PMC9679489 DOI: 10.1016/j.ijscr.2022.107783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Endodermal Sinus tumor is a rare malignant type of germ cell tumor (GCT). Primary endodermal sinus tumor, especially in the head of pancreas, is extremely rare. The case under consideration is of a 22 year old male who presented with pancreatic mass causing postprandial nausea and vomiting, and raised AFP levels. The biopsy of the mass revealed the endodermal sinus tumor, and the pancreatic origin was confirmed by a CT scan and a negative scrotal ultrasound. As the tumor was unresectable initially, a gastrojejunostomy was done to relieve the obstructive symptoms. Whipple procedure was performed two months after 4 cycles of BEP chemotherapy to remove the residual tumor in pancreas. It is crucial to highlight this uncommon case in order to increase surgeons' and oncologists' knowledge of the malignant extra-gonadal GCTs diagnosis and treatment.
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Galanis I, Floros G, Simou M, Kyriakopoulos G, Stylianidis G. An Extremely Rare Case of a Primary Pancreatic Yolk Sac Tumor. Cureus 2022; 14:e26007. [PMID: 35859959 PMCID: PMC9288229 DOI: 10.7759/cureus.26007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 11/22/2022] Open
Abstract
Yolk sac tumor (YST) is a rare malignant type of germ cell tumor (GCT). Extragonadal yolk sac tumor is a very rare entity. We report the case of a 33-year-old male with a pancreatic mass, which proved to be a primary yolk sac tumor, arising in the pancreas.
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Wu N, Chen Q, Chen M, Ning J, Peng S, Zhang T, Zhong W, Duan S, Cheng C, Xie Y. Primary Yolk Sac Tumor in the Cerebellar Hemisphere: A Case Report and Literature Review of the Rare Tumor. Front Oncol 2021; 11:739733. [PMID: 34804928 PMCID: PMC8602065 DOI: 10.3389/fonc.2021.739733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Yolk sac tumor (YST) is one of rare malignant germ cell tumors (GCTs). Primary intracranial YST, also endodermal sinus tumor (EST), is a quite rare type of brain tumor. Here, we report a case of YST, review the relevant literature, and propose a treatment strategy for this rare tumor. A 6-year-old boy initially manifested symptoms of dizziness and vomiting. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large irregular oval tumor in the cerebellar hemisphere. We subtotally removed the tumor by microsurgery through the left suboccipital approach. Immunohistochemical staining showed that alpha fetoprotein (AFP) was positive and the Ki-67 proliferation index was high (60%), suggesting a germ cell tumor. After 3 months of follow-up, neither recurrence of tumor nor complications were found in the patient. The diagnosis of YST should be confirmed on the basis of clinical manifestations, neuroimaging and pathological findings. Gross total resection (GTR) is an ideal treatment for YST. However, due to the location of the tumor, GTR is usually difficult, and the rate of postoperative complications is high. This reported case shows that subtotal resection can be a good treatment strategy for YST.
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Affiliation(s)
- Na Wu
- Department of Pediatric Surgery/Pathology/Radiology/Sleep Medicine Center, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Qiang Chen
- Department of Pediatric Surgery/Pathology/Radiology/Sleep Medicine Center, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Meng Chen
- Department of Pediatric Surgery/Pathology/Radiology/Sleep Medicine Center, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Jinbo Ning
- Department of Pediatric Surgery/Pathology/Radiology/Sleep Medicine Center, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Shulei Peng
- Department of Pediatric Surgery/Pathology/Radiology/Sleep Medicine Center, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Taotao Zhang
- Department of Pediatric Surgery/Pathology/Radiology/Sleep Medicine Center, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Wen Zhong
- Department of Pediatric Surgery/Pathology/Radiology/Sleep Medicine Center, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Song Duan
- Department of Pediatric Surgery/Pathology/Radiology/Sleep Medicine Center, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Chongjie Cheng
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yimin Xie
- Department of Pediatric Surgery/Pathology/Radiology/Sleep Medicine Center, Chongqing University Three Gorges Hospital, Chongqing, China
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Sui H, Zhu Z, Li Z, Luo Y. Primary Pancreatic Yolk Sac Tumor Presenting as Diffusely Enlarged Pancreas in Initial 18F-FDG PET/CT. Clin Nucl Med 2020; 45:483-486. [PMID: 32332317 DOI: 10.1097/rlu.0000000000003038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Yolk sac tumor is a rare and highly malignant germ cell tumor. We report a case of yolk sac tumor primarily in the pancreas in a 32-year-old man. He presented with pancreatitis at presentation with significantly increased serum alpha-fetoprotein (AFP). F-FDG PET/CT revealed diffuse enlargement of the pancreas in the neck, body, and tail portion with homogeneously increased FDG uptake, similar to the change of pancreatitis. The lesion progressively developed to a huge pancreatic mass in the follow-up images, and endoscopic ultrasonography-guided aspiration biopsy of the pancreatic mass confirmed the diagnosis of yolk sac tumor.
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Affiliation(s)
- Huimin Sui
- From the Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and PUMC; and Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, People's Republic of China
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Yolk sac tumor of endometrium: A case report and literature review. Taiwan J Obstet Gynecol 2020; 58:846-848. [PMID: 31759539 DOI: 10.1016/j.tjog.2019.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To report a rare case of endometrial yolk sac tumor (YST) and review published cases of YST of the endometrium. CASE REPORT A 68-year-old female presented with intermittent vaginal spotting for nine months. An endometrial biopsy showed adenocarcinoma. Complete surgical staging operation was performed and the final pathology revealed stage II endometrial yolk sac tumor. The post-operative α-fetoprotein (AFP) level was 133.4 ng/mL. Post-operative adjuvant chemotherapy with bleomycin, etoposide, and cisplatin (BEP) regimen was prescribed for 6 cycles. AFP levels were normal before the fourth cycle of chemotherapy. She is disease free 6 months after completion of therapy. CONCLUSION Primary YSTs arising in the endometrium is an extremely rare disease especially in postmenopausal women. Complete surgical staging operation with adjuvant chemotherapy will lead to good outcome in this disease.
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Yonemaru J, Takahashi M, Nara S, Ichikawa H, Ishigamori R, Imai T, Hiraoka N. A yolk sac tumor of the pancreas and derived xenograft model effectively responded to VIP chemotherapy. Pancreatology 2020; 20:551-557. [PMID: 31917123 DOI: 10.1016/j.pan.2019.12.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/19/2019] [Accepted: 12/27/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Yolk sac tumors (YSTs) of the pancreas are extremely rare, and no drug responsiveness data are available regarding YSTs. METHODS We report a pancreatic YST in a 70-year-old woman, and its chemotherapeutic responsiveness based on clinical records and evaluation of a patient-derived xenograft (PDX) line of the YST. RESULTS The YST was an 11-cm, solid mass located in the pancreatic tail. Histologically, the tumor showed medullary proliferation of tumor cells, with a variety of growth patterns including microcystic/reticular, endodermal sinus, and hepatoid patterns. Immunohistochemically, the tumor cells were positive for Sall4, glypican-3, and alpha-fetoprotein. We administered VIP (etoposide, ifosfamide, cisplatin) chemotherapy for a recurrent liver tumor, and obtained complete pathological remission. A drug-response assay using the PDX line from this YST revealed that both VIP and gemcitabine effectively inhibit tumor growth. CONCLUSIONS These results suggest that differential diagnosis of YST from adenocarcinoma is important for selecting appropriate chemotherapy.
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Affiliation(s)
- Junpei Yonemaru
- Division of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Mami Takahashi
- Central Animal Division, National Cancer Center Research Institute, Tokyo, Japan
| | - Satoshi Nara
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hitoshi Ichikawa
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Rikako Ishigamori
- Central Animal Division, National Cancer Center Research Institute, Tokyo, Japan
| | - Toshio Imai
- Central Animal Division, National Cancer Center Research Institute, Tokyo, Japan
| | - Nobuyoshi Hiraoka
- Division of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan; Division of Molecular Pathology, National Cancer Center Research Institute, Tokyo, Japan.
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Song L, Wei X, Wang D, Yang K, Qie M, Yin R, Li Q. Primary yolk sac tumor originating from the endometrium: A case report and literature review. Medicine (Baltimore) 2019; 98:e15144. [PMID: 30985686 PMCID: PMC6485813 DOI: 10.1097/md.0000000000015144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Yolk sac tumors (YSTs) are malignant germ cell tumors that secrete alpha-fetoprotein (AFP). These tumors commonly develop in infants, young children, and young women and often originate in the gonads. Primary endometrial YST is a very rare malignancy, and a primary endometrial YST in the absence of abnormal AFP levels is even rarer. PATIENT CONCERNS A 38-year-old woman presented with the chief complaint of prolonged menstruation and increased menstrual bleeding with a duration of more than 2 months. DIAGNOSES Postoperative pathology confirmed a diagnosis of endometrial YST with metastasis to the greater omentum (stage IVB). INTERVENTIONS The patient underwent a laparoscopic extrafascial hysterectomy, bilateral adnexectomy, pelvic lymphadenectomy, abdominal para-aortic lymphadenectomy, omentectomy, and appendectomy. Additionally, she received 6 courses of multidrug chemotherapy (bleomycin, etoposide, and cisplatin; BEP). OUTCOMES After completing chemotherapy, the patient underwent regular follow-up examinations. No recurrence was noted during a 24-month follow-up period. LESSONS YST is mainly treated using surgery and chemotherapy, which may spare endocrine functions in young patients. The BEP regimen appears to be an effective postoperative chemotherapy regimen for patients with endometrial YST.
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Affiliation(s)
- Liang Song
- The Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education
| | - Xiaoxia Wei
- Department of Pathology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Danqing Wang
- The Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education
| | - Kaixuan Yang
- Department of Pathology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Mingrong Qie
- The Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education
| | - Rutie Yin
- The Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education
| | - Qingli Li
- The Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education
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Pal R, Bhaumik J, Arun I. Endodermal Sinus Tumour of the Uterine Cervix: A Case Report. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2017. [DOI: 10.1007/s40944-017-0130-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
We present the clinicopathologic features of 15 cases of extragonadal yolk sac tumor (EGYST) detected in female patients and reviewed at our institution from 1988 to 2016. We recorded: patient age, clinical presentation, tumor location, FIGO stage (where applicable), histologic patterns including presence/absence of Schiller-Duval bodies, other germ cell or somatic components, immunoperoxidase results, treatment, and outcome. Patients' ages ranged from 17 to 87 (median, 62) years and presentation included: abnormal uterine bleeding, 12; hematuria, 1; labial mass, 1; abdominal pain, 1. Primary sites were as follows: uterus (11), vagina (1), vulva (1), bladder (1), and peritoneum (1). Seven patients presented at FIGO stage III or IV. The following histologic patterns were observed: microcystic/reticular (7), glandular (8), solid (8), papillary (5), and hepatoid (1). An admixture of histologic patterns was present in 10 cases. Schiller-Duval bodies were seen in only 3 (23%) cases. Eight cases (46%), all uterine primaries, had associated somatic components, and 2 (15%) had a second germ cell component. In 13/14 (93%) cases, the yolk sac tumor component was either missed or misclassified as adenocarcinoma. Immunoperoxidase studies facilitated the diagnosis in all cases as follows: SALL4, 12/12; CDX2, 10/12; α fetoprotein, 7/14; glypican-3, 9/10; cytokeratin 20, 5/9 (rare cells); cytokeratin 7, 3/12 (nondiffuse); PAX8, 2/9 (variable expression). All patients received chemotherapy and all except 1 underwent surgical resection. Follow-up from 5 to 86 months was available for 13 patients: 5 died of disease, 6 are alive with disease, and 2 have no evidence of disease. EGYST arising in the female pelvis of peri/postmenopausal patients may be associated with a somatic component and represent either somatically derived YST or YST differentiation within a somatic carcinoma. EGYST in younger patients is likely a true germ cell neoplasm, and may respond to germ cell appropriate chemotherapy. The benefit of germ cell appropriate chemotherapy in somatically derived EGYST is less clear. Awareness that the presence of glandular or microcystic patterns may lead to under-recognition or misdiagnosis of EGYST in combination with immunomarkers for germ cell and yolk sac differentiation will facilitate the diagnosis.
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Euscher ED. Unusual Presentations of Gynecologic Tumors: Extragonadal Yolk Sac Tumor of the Vulva. Arch Pathol Lab Med 2016; 141:293-297. [PMID: 27959583 DOI: 10.5858/arpa.2016-0151-sa] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Extragonadal germ cell tumors are uncommon, and although they morphologically resemble their gonadal counterparts, unexpected gonadal presentation increases the potential for erroneous diagnoses. Yolk sac tumor is a malignant germ cell tumor characterized by an extraembryonic yolk sac line of differentiation, and relative to other germ cell tumors, is characterized by varied and diverse histologic patterns. When occurring outside of typical age parameters or in extragonadal locations, the histologic variability of yolk sac tumor and its tendency to mimic somatic tumors pose diagnostic challenges. Because extragonadal yolk sac tumor of the vulva is very rare, with only isolated case reports and small series in the literature, it is often not considered in the differential diagnosis. As both prognosis and management of yolk sac tumor differ significantly from those of somatic tumors, accurate diagnosis is essential. This review discusses histologic features of extragonadal yolk sac tumor, addresses somatic tumors arising in the vulva for which yolk sac tumor may be confused, and provides guidance with respect to the use of immunohistochemistry in the diagnosis of yolk sac tumor.
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Zeremski V, Mawrin C, Fischer T, Schalk E. Diagnostic and therapeutic challenges in extragonadal yolk sac tumor with hepatoid differentiation: A case report. Mol Clin Oncol 2016; 6:79-82. [PMID: 28123734 DOI: 10.3892/mco.2016.1080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/13/2016] [Indexed: 01/19/2023] Open
Abstract
Yolk sac tumors (YSTs) are rare aggressive tumors, arising most commonly in the gonads and occurring mainly in young adults. We herein report a case of an extragonadal YST with hepatoid differentiation localized in the brain and lung. A 41-year old man presented to our hospital with a generalized seizure. A head computed tomography and magnetic resonance imaging examination revealed a large mass in the left occipital lobe with associated edema. Following complete resection, the histopathological examination revealed that the mass was a highly malignant epithelial tumor with a hepatoid pattern. The serum lactate dehydrogenase and α-fetoprotein levels were elevated. Additional diagnostic imaging revealed a lesion in the upper lobe of the right lung, but no other tumor manifestations. Based on the clinical and immunohistochemical characteristics, hepatocellular carcinoma and hepatoid adenocarcinoma were excluded and the diagnosis of extragonadal hepatoid YST was established. A multimodal therapeutic approach (high-dose chemotherapy with autologous stem cell transplantation, radiation and surgery) was applied; however, the patient succumbed to refractory disease 10 months after the diagnosis. Therefore, the diagnosis and treatment of hepatoid YST is an interdisciplinary challenge.
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Affiliation(s)
- Vanja Zeremski
- Department of Hematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, D-39120 Magdeburg, Germany
| | - Christian Mawrin
- Department of Neuropathology, Medical Center, Otto-von-Guericke University Magdeburg, D-39120 Magdeburg, Germany
| | - Thomas Fischer
- Department of Hematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, D-39120 Magdeburg, Germany
| | - Enrico Schalk
- Department of Hematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, D-39120 Magdeburg, Germany
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Li Y, Zheng Y, Lin J, Xu G, Cai A, Chen R, Wu M. Radiological-pathological correlation of yolk sac tumor in 20 patients. Acta Radiol 2016; 57:98-106. [PMID: 25492969 DOI: 10.1177/0284185114561916] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 11/07/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND Yolk sac tumor (YST) is a rare tumor. Familiarity of its radiological characteristics may permit preoperative diagnosis and improve surgical management of patients. However, a detailed description of the imaging features of YST with pathological correlation in particular is scarce. PURPOSE To investigate computed tomography (CT) findings of YSTs with pathological correlation. MATERIAL AND METHODS CT images of 20 patients with pathologically proven YST were retrospectively reviewed. The location, size, margin, internal architecture, and pattern and degree enhancement of the lesion were evaluated. Radiological findings were correlated with pathological results. RESULTS The locations of 20 tumors were distributed between the testis (n = 3), ovary (n = 6), sacrococcygeal area (n = 6), rectum (n = 1), and mediastinum (n = 4). The median age was 13 years. On CT images, all tumors were seen as oval (n = 14) or irregular (n = 6), well-defined (n = 16) or ill-defined (n = 4) masses with a mean size of 9.7 cm. The lesions were solid cystic (n = 10), entirely solid (n = 6), or predominantly cystic (n = 4). Intratumoral hemorrhage, calcification, and fatty tissue were seen in nine, three, and two tumors, respectively. Discontinuity of the tumor wall was seen in eight tumors. After contrast media administration, most tumors showed heterogeneous moderate to marked enhancement (n = 7) or heterogeneous marked enhancement (n = 9). Enlarged intratumoral vessels were seen in 17 tumors. CONCLUSION YST usually appears as a large solid-cystic mass with intratumoral hemorrhage, capsular tear, marked heterogeneous enhancement, and enlarged intratumoral vessels on CT images. Intratumoral calcification and fatty tissue, although rare, may indicate a mixed YST containing teratoma component.
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Affiliation(s)
- YangKang Li
- Department of Radiology, Cancer Hospital, Shantou University Medical College, Shantou, PR China
| | - Yu Zheng
- Department of Clinical Pharmacology, Cancer Hospital, Shantou University Medical College, Shantou, PR China
| | - JianBang Lin
- Department of Radiology, Cancer Hospital, Shantou University Medical College, Shantou, PR China
| | - GuiXiao Xu
- State Key Laboratory of Oncology in South China, Department of Diagnostic Imaging and Intervening Center, Cancer Center of Sun Yat-sen University, Guangzhou, PR China
| | - AiQun Cai
- Department of Radiology, Cancer Hospital, Shantou University Medical College, Shantou, PR China
| | - RuoWei Chen
- Department of Diagnostic Imaging, the Second affiliated Hospital of Shantou University Medical College, Shantou, PR China
| | - MingYao Wu
- Department of Pathology, Shantou University Medical College, Shantou, PR China
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Kuang H, Zhang C, Gong H, Guo L, Yu C, Zeng X. Primary cerebellar endodermal sinus tumor: A case report. Oncol Lett 2014; 8:1713-1716. [PMID: 25202397 PMCID: PMC4156216 DOI: 10.3892/ol.2014.2340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 06/16/2014] [Indexed: 11/08/2022] Open
Abstract
Endodermal sinus tumors are rare malignant germ cell tumors that usually originate from the gonads and are rarely observed extragonadally. Pure primary endodermal sinus tumors of the cerebellar hemisphere are extremely rare and patients diagnosed with the disease often have a poor prognosis. The symptoms of YSTs are unspecific and associated with the location of tumors. Intracranial YSTs (such as cerebellar hemispheres) always present with symptoms including headache and poor vision. The present study reports the case of a three-year-old male who presented to The First Affiliated Hospital of Nanchang University (Nanchang, China) with a headache that had persisted for one month, and then worsened for the last 10 days. This was accompanied by vomiting and gait disturbance. An abnormal signal mass was identified in the left cerebellar hemisphere on brain magnetic resonance imaging. The case initially presented as a medulloblastoma and the patient was followed up for six months. The final pathology report revealed an endodermal sinus tumor, also known as a yolk sac tumor. Six months following resection of the left cerebellar tumor, the patient succumbed to recurrence of the disease, due to acute vomiting and severe headache.
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Affiliation(s)
- Hongmei Kuang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Chun Zhang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Linghong Guo
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Chen Yu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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Wang J, Zheng Z, Qiu Y, Tou J, Liu W, Xiong Q, Gu W, Gao Z. Primary mixed germ cell tumor arising in the pancreatic head. J Pediatr Surg 2013; 48:e21-4. [PMID: 23331834 DOI: 10.1016/j.jpedsurg.2012.10.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 10/17/2012] [Accepted: 10/23/2012] [Indexed: 11/26/2022]
Abstract
Germ cell tumors, comprised of gonadal and extra-gonadal types, are relatively rare tumors arising from primordial germ cells. Extra-gonadal germ cell tumors have been reported to occur at many non-gonadal locations, from the brain to the sacrococcygeal region. However, primary germ cell tumors in the pancreas are extremely rare. Herein, we present the first case of a 12-month-old girl with a primary mixed germ cell tumor, consisting of both endodermal sinus tumor and mature teratoma, in the pancreatic head.
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Affiliation(s)
- Jinhu Wang
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Bouassida M, Sassi S, Laajili A, Mighri M, Touinsi H, Sassi S. [Management of extragonadic Yolk sac tumor with hepatic metastasis]. Presse Med 2012; 41:1158-60. [PMID: 22326666 DOI: 10.1016/j.lpm.2011.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 12/03/2011] [Accepted: 12/12/2011] [Indexed: 11/30/2022] Open
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Rossi R, Stacchiotti D, Bernardini MG, Calvieri G, Lo Voi R. Primary yolk sac tumor of the endometrium: a case report and review of the literature. Am J Obstet Gynecol 2011; 204:e3-4. [PMID: 21345404 DOI: 10.1016/j.ajog.2010.12.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Revised: 11/28/2010] [Accepted: 12/07/2010] [Indexed: 11/16/2022]
Abstract
We describe a rare case of a primary yolk sac tumor of the endometrium treated with a simple total hysterectomy without bilateral salpingo-oophorectomy and 3 cycles of the bleomycin, etoposide and cisplatin regimen.
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Affiliation(s)
- Roberto Rossi
- Obstetric and Gynecologic Unit, Mazzoni Hospital, Ascoli Piceno, Italy.
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