Mixed Germ Cell Tumor with Extensive Yolk Sac Tumor Elements in the Frontal Lobe of an Adult

Intracranial nongerminomatous germ cell tumors (NGGCTs) in unusual locations are extremely rare. Here, we report a case of a yolk sac tumor in the frontal lobe in a middle-aged patient. A 42-year-old man was admitted to our hospital for headache and nausea. Magnetic resonance imaging (MRI) showed an enhanced mass lesion with a marked cyst component. The serum alpha-fetoprotein (αFP) level was extremely high. Histological examination of specimens after subtotal removal revealed a primary mixed germ cell tumor with extensive yolk sac tumor elements, often referred to as an intracranial “yolk sac tumor.” The preoperative diagnosis of NGGCTs in unusual age and locations is extremely difficult. Clinicians should consider the possibility of NGGCTs, including yolk sac tumors, when intracranial tumors with unusual MRI findings are encountered.

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Mediastinal mixed germ cell tumor: A case report and literature review

Open Medicine ◽

10.1515/med-2021-0293 ◽

2021 ◽

Vol 16 (1) ◽

pp. 892-898

Author(s):

Xianwen Hu ◽

Dandan Li ◽

Jinhua Xia ◽

Pan Wang ◽

Jiong Cai

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Embryonal Carcinoma ◽

Yolk Sac ◽

Immature Teratoma ◽

Cell Tumor ◽

Yolk Sac Tumor ◽

Medical Attention ◽

Ct Guided ◽

Mixed Germ Cell Tumor

Abstract Mixed germ cell tumor (MGCT) mainly occurs in young women’s ovaries and men’s testicles and rarely occurs outside the gonad. Fewer than 10 cases of mediastinal MGCT are available in PubMed, Embase, and other databases in English, while mediastinal MGCT with three pathological components, such as yolk sac tumor, immature teratoma, and embryonal carcinoma, has not been reported previously. A 12-year-old male sought medical attention for chest discomfort and underwent a computed tomography (CT) scan. A large soft tissue mass occupying most of the left thoracic cavity and mediastinum was detected. A CT-guided biopsy was performed, and an MGCT was diagnosed with pathological components, including yolk sac tumor, immature teratoma, and a small amount of embryonal carcinoma. Due to the large size of the tumor, the patient was treated with an EP regimen (etoposide + cisplatin) and paclitaxel + ifosfamide + cisplatin interstitial chemotherapy. The patient was followed up for 6 months and was alive with the disease. To the best of our knowledge, this is the 10th patient with MGCT in the mediastinum. The incidence of mediastinal MGCT is low, but it should still be considered one of the differential diagnoses of isolated pleural fibroma and neurogenic tumors.

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Pediatric Germ Cell Tumors: An Experience of 7 Years in a Tertiary Hospital of Bangladesh

Dhaka Shishu (Children) Hospital Journal ◽

10.3329/dshj.v35i2.49692 ◽

2020 ◽

Vol 35 (2) ◽

pp. 119-122

Author(s):

SM Rashed Zahangir Kabir ◽

Md Waheed Akhtar ◽

Farida Yasmin

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Tertiary Care ◽

Germ Cell Tumors ◽

Yolk Sac ◽

Cell Tumor ◽

Yolk Sac Tumor ◽

Treatment Modalities ◽

Care Hospital ◽

Childhood Malignancies

Introduction: Germ cell tumors are a group of tumors with different clinical presentation and histological and biological characteristics. Malignant germ cell tumors occur at all ages with a trend of bimodal distribution in infancy and adolescence. Objective: To evaluate the demographic characteristics, distribution of different types of germ cell tumor, treatment modalities and outcome of germ cell tumor in children in a tertiary care hospital of Bangladesh. Methods: In this retrospective study, data regarding age and sex distribution, location, types of tumors, management of germ cell tumor in children were retrieved from the medical records of pediatric oncology department in NICRH, Dhaka from 2008 to 2014. Results: Out of total 87 patients female were 50 and male 37. Most of the patients were up to 5 years of age. The gonadal germ cell tumors (80%) were more than extragonadal tumor (20%) in both male and female patients. The most common germ cell tumor was dysgerminoma (32%) followed by yolk sac tumor (29.8%) and teratoma (19.5%). Yolk Sac Tumor (51.4%) was the most common in male and dysgerminoma (56%) the commonest in female. Out of 87, seventy two (82.7%) received chemotherapy following surgery. Among those 72 patients who received chemotherapy 49 (68 %) patients completed their treatment. Until the last follow up 71.4% patients remained alive and tumor free. Conclusion: Germ cell tumors are the most variable tumor of all childhood malignancies that has difference in age, sex, location and histological subtypes. Gonadal tumors have better prognosis than extragonadal tumors in both the sex. DS (Child) H J 2019; 35(2) : 119-122

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Occurrence of metachronous pure germinomas long after treatment of a mixed germ cell tumor containing yolk sac tumor and germinoma

Journal of Neurosurgery Pediatrics ◽

10.3171/2012.9.peds12151 ◽

2013 ◽

Vol 11 (1) ◽

pp. 68-73 ◽

Cited By ~ 6

Author(s):

Shinya Jinguji ◽

Kouichirou Okamoto ◽

Junichi Yoshimura ◽

Yuichiro Yoneoka ◽

Ryousuke Ogura ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Initial Treatment ◽

De Novo ◽

Good Prognosis ◽

Yolk Sac ◽

Cell Tumor ◽

Yolk Sac Tumor ◽

Mixed Germ Cell Tumor ◽

Prognosis Group

The authors report a rare case involving the occurrence of metachronous pure germinomas long after treatment of a mixed germ cell tumor (GCT) categorized as having a poor prognosis. A neurohypophysial germinoma occurred 4 years and 6 months after the initial treatment of a mixed pineal GCT containing a yolk sac tumor and a germinoma. Furthermore, intramedullary germinomas occurred 21 years after the initial treatment of the mixed GCT and 15 years after the second treatment of the neurohypophysial germinoma. The neurohypophysial germinoma was not confirmed histopathologically, but the intramedullary germinoma was histopathologically diagnosed as a pure germinoma. Serum α-fetoprotein levels at the second neurohypophysial and third intramedullary occurrences of the germinomas were less than 10 ng/ml. Therefore, no yolk sac components seemed to be contained in the tumors. The second neurohypophysial and third intramedullary germinomas might be recurrences of the germinoma component of the pineal mixed GCT, which consisted of a yolk sac tumor and a germinoma. However, it seems very unlikely that only the germinoma, categorized in the good prognosis group, would be the only one to recur. Hence, it seems plausible that both the second and the third occurrences of pure germinoma were de novo metachronous GCTs arising after the pineal mixed GCT was cured. The authors' case indicates the possibility of multicentric GCTs in the CNS.

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SEMINOMA ANAPLASTIK DENGAN YOLK SAC TUMOR TESTIS (MIXED GERM CELL TUMOR TESTIS)

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.4.3.2012.1214 ◽

2013 ◽

Vol 4 (3) ◽

Author(s):

Lily Loho

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Testicular Tumor ◽

Yolk Sac ◽

Cell Tumor ◽

Yolk Sac Tumor ◽

Mixed Germ Cell Tumor ◽

Β Hcg

Abstract: Testicular cancer is relatively rare, accounting for less than 1% of malignant tumors affecting men. More than 90% of these tumors are of germ cell origin and most of them are found in young men between the ages of 15-34 years. Germ cell tumors are divided into seminoma and nonseminoma tumors. The seminoma makes up 30-40% of all testicular tumors. An anaplastic seminoma is a classic type of seminoma that has three or more mitosis under the high power microscopic field, combined with other morphologic criteria such as nuclear hyperchromasia, greater nucleolar sizes, pleomorphism, and an amount of necrosis. We reported a case of a 38-year-old male that was clinically diagnosed with a left testicular tumor and with an elevated alpha fetoprotein (AFP) and β human chorionic gonadotropin (β HCG) serum. The histopathological diagnosis was an anaplastic seminoma with a yolk sac tumor (YCT), i.e. a mixed germ cell tumor. Keywords: seminoma, testicular tumor, yolk sac tumor. Abstrak: Kanker testis relatif jarang, <1% dari semua kanker ganas pada laki-laki. Lebih dari 90 persen jenis tumor ini berasal dari sel germinal dan umumnya menyerang laki-laki muda berusia 15-34 tahun. Tumor sel germinal dibagi atas dua jenis: seminoma dan non seminoma. Jenis seminoma terdapat pada 30-40% dari seluruh tumor testis. Seminoma anaplastik adalah seminoma dengan ciri klasik mikroskopik berupa adanya tiga atau lebih sel-sel mitosis per lapangan pandang besar, disertai terdapatnya kriteria morfologik lain seperti inti sel hiperkromatik, anak inti berukuran besar, pleomorfik, dan terdapatnya sejumlah nekrosis. Kami melaporkan kasus seorang laki-laki berusia 38 tahun dengan diagnosis klinis tumor testis kiri disertai peningkatan kadar alfa feto protein (AFP) dan β human chorionic gonadotropin (β HCG) serum. Diagnosis histopatologik ialah seminoma anaplastik dengan tumor yolk sac (YCT), yaitu tumor sel germinal campuran. Kata kunci: seminoma, tumor testis, tumor yolk sac.

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Yolk Sac Tumor of the Temporal Lobe: Case Report

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0035-1564829 ◽

2015 ◽

Vol 37 (03) ◽

pp. 247-251

Author(s):

Ana Machado ◽

Ricardo Taipa ◽

Manuel Pires ◽

Carla Silva ◽

Mário Gomes

Keyword(s):

Germ Cell ◽

Temporal Lobe ◽

Germ Cell Tumor ◽

Germ Cell Tumors ◽

High Grade Glioma ◽

Yolk Sac ◽

Cell Tumor ◽

Temporal Lobectomy ◽

Yolk Sac Tumor ◽

Primary Tumors

AbstractGerm cell tumors of the central nervous system (CNS) are usually located along the midline. Yolk sac tumor is a rare germ cell tumor very uncommonly located outside the midline, and, in such cases, it can be mistaken with other primary tumors. We report a case of a 32-year-old male patient who presented with a right temporal lobe tumor suggestive of a high grade glioma. He was submitted to a right temporal lobectomy with complete tumor removal. The histological exam revealed a germ cell tumor (later confirmed to be a yolk sac tumor). The search for a primary tumor outside of the CNS (including a positron emission tomography scan) was negative, making this a primary temporal lobe yolk sac tumor. The patient was submitted to chemotherapy and radiotherapy, but died 7 months after the surgery.

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The Role of Surgical Resection as A Salvage Therapy and Immunohistochemical Stain to Confirm Mediastinal Yolk Sac Tumor

Malang Respiratory Journal ◽

10.21776/ub.mrj.2020.002.01.3 ◽

2020 ◽

Vol 2 (1) ◽

pp. 49-55

Author(s):

Dwi Agustina ◽

◽

Suryanti Pratiwi ◽

Diah Retnani ◽

Artono Isharanto ◽

...

Keyword(s):

Case Report ◽

Germ Cell ◽

Germ Cell Tumor ◽

Germ Cell Tumors ◽

Vena Cava ◽

Yolk Sac ◽

Cell Tumor ◽

Yolk Sac Tumor ◽

Term Survival ◽

Immunohistochemical Stain

Background: Mediastinal germ cell tumors are uncommon, representing less than 1% of all malignancies. They mostly occur in young men after puberty and have a poor prognosis with over all long term survival rate 42%. Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a young man, 26 years old with an anterior mediastinum tumor and VCSS The CT scan of the chest showed an anterosuperior mediastinal mass which compress the superior vena cava. The result from transthoracic FNAB with USG guidance showed an extragonadal germ cell tumor which resemble an Embryonal Carcinoma from mediastinum. The AFP serum level was elevated. Patient underwent a radiotherapy and a surgical debulking. The biopsy showed an Endodermal Sinus Tumor (Yolk Sac). Immunohistochemical stain for cytokeratin was positive in the tumor cells while stain for CD30 was negative. These were confirming the diagnosis of primary mediastinal yolk sac tumor. Patient received a combination chemotherapy for a total 6 cycles. Conclusion: Some procedures like biopsy, tumor marker, immunohistochemical stain, could differentiate the subtype of mediastinal germ cell tumor. The multimodality treatment by combining chemotherapy with surgical therapy or radiotherapy could increase the survival outcome of patients.

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Primary Intracranial Mixed Germ-Cell Tumors in Adult: MR Findings

Rivista di Neuroradiologia ◽

10.1177/197140090501800216 ◽

2005 ◽

Vol 18 (2) ◽

pp. 231-234

Author(s):

G.Q. Wei ◽

Y. Huan ◽

H.D. He ◽

L.J. Sun ◽

Y. Yang ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Preoperative Diagnosis ◽

Germ Cell Tumors ◽

Cell Tumor ◽

Mri Findings ◽

Mixed Germ Cell Tumor ◽

Imaging Characteristics ◽

Suprasellar Region ◽

Mixed Germ Cell Tumors

The incidence of primary intracranial mixed germ-cell tumor varies geographically. Preoperative diagnosis is of great importance in treatment planning. We describe the clinical and MRI findings of a case of mixed germ-cell tumors in the suprasellar region with emphasis on the imaging characteristics suggesting the histological diagnosis.

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