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Yolk Sac Tumor

Endodermal Sinus Tumor


Presentation

  • These usually present with per vaginal bleeding and vaginal mass. Presentation with discharged tumor fragments is very unusual.[ncbi.nlm.nih.gov]
  • We present a child with calvarial metastasis which was the presenting symptom of an otherwise asymptomatic large malignant mediastinal germ cell tumor (GCT).[ncbi.nlm.nih.gov]
  • Albeit an uncommon etiology for heart failure, germ cell tumors can potentially metastasize to the heart and present with such a clinical picture.[ncbi.nlm.nih.gov]
  • He underwent resection, received platinum-based chemotherapy and presently remains well on follow-up.[ncbi.nlm.nih.gov]
  • 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.[ncbi.nlm.nih.gov]
Fatigue
  • When symptoms do occur, they may include the following: Nausea Vomiting Headache Cough Fever Changes in bowel function or habits Fatigue Problems with breathing Weight loss Night sweats Symptoms for location-specific endodermal sinus tumor may include[stjude.org]
  • Fatigue, hemoptysis and superior vena cava syndrome were seen in less than 10% of patients with mediastinal GCT. 1, 7 Some clinical conditions are associated with yolk sac tumor, according to literature, such as Klinefelter syndrome (around 20% of cases[scielo.br]
  • Patients with mediastinal GCTs usually present with dyspnea (25%), chest pain (23%), cough (17%), followed by fever (13%), weight loss (11%), vena cava superior syndrome (6%), fatigue/weakness (6%), and pain at other location except the chest (5%).[exp-oncology.com.ua]
  • Tumors in the pineal region of the brain can cause these symptoms: Increased fluid in the brain (hydrocephalus) Headache Vomiting Fatigue Feeling irritable Double vision Trouble looking up or focusing on close objects Coordination and balance issues Tumors[stjude.org]
Soft Tissue Mass
  • CT scan abdomen revealed well-defined, soft tissue mass, about 11x10 cm between rectum and urinary bladder. Mass showed internal necrotic changes and enhancement along the walls. No calcification was seen. Exploratory laparotomy was done.[ncbi.nlm.nih.gov]
  • Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a lobulated soft tissue mass in paranasal sinus that extended to oral cavity, nasopharynx, and oropharynx.[ncbi.nlm.nih.gov]
  • Computed tomography (CT) head and neck revealed a large solid soft tissue mass with cystic areas causing destruction of the left mandible [Figure 1] a].[cancerjournal.net]
  • Computed tomography (CT) abdomen revealed large heterogeneously enhancing soft-tissue mass lesion in the lesser sac with indistinct fat planes with the lesser curvature of the stomach with multiple peripherally enhancing lesions in both lobes of liver[jiaps.com]
Lymphedema
  • To avoid complications of inguinal LND, such as lymphedema, inguinal sentinel lymph node biopsy (SLNB) can be considered [2,3].[ncbi.nlm.nih.gov]
Abdominal Pain
  • Abstract We are presenting a case of a 13-year-old girl with a chief complaint of lower abdominal pain. A computed tomographic scan showed a 10-cm right ovarian mass. The serologic testing showed high alpha-fetoprotein level.[ncbi.nlm.nih.gov]
  • 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.[ncbi.nlm.nih.gov]
  • pain in the right fossa.[jbsr.be]
  • The patients presented with abdominal pain and swelling. Their serum AFP level was elevated. Seven tumors were unilateral, one was bilateral and three had extraovarian spread.[ijpmonline.org]
  • A 43-year-old male presented with left upper abdominal pain, mildly tender palpable mass, normal genitals, and unremarkable previous surgical issues.[indianjurol.com]
Nausea
  • She had a fever up to 38,4 C without any complaints of nausea, vomiting or diarrhea. How to Cite: Thielen TV, Degryse H, Coeman D. Yolk sac tumor of the ovary. Journal of the Belgian Society of Radiology. 2013;96(4):256–7.[jbsr.be]
  • When symptoms do occur, they may include the following: Nausea Vomiting Headache Cough Fever Changes in bowel function or habits Fatigue Problems with breathing Weight loss Night sweats Symptoms for location-specific endodermal sinus tumor may include[stjude.org]
  • Less frequent symptoms were chest wall or cervical mass (2%), and hemoptysis, hoarseness, nausea, or dysphagia (1% each) [3]. The computed tomography scan revealed the bulky mass with cystic component infiltrating to the right atrium.[exp-oncology.com.ua]
  • Then, she was brought to the Pediatrics outpatient department with nausea, vomiting and lower abdominal pain for 2 months. On physical examination, lower abdomen tenderness, and pale looking were noted.[frontiersin.org]
  • Medicines and other treatments can be used for pain, fever, infection, and nausea and vomiting. With any cancer, how well a child is expected to recover (prognosis) varies.[stanfordchildrens.org]
Diarrhea
  • She had a fever up to 38,4 C without any complaints of nausea, vomiting or diarrhea. How to Cite: Thielen TV, Degryse H, Coeman D. Yolk sac tumor of the ovary. Journal of the Belgian Society of Radiology. 2013;96(4):256–7.[jbsr.be]
  • CASE PRESENTATION A 22 year-old woman was admitted to the emergency room with severe lower abdominal pain, nausea, diarrhea, and fever.[ncbi.nlm.nih.gov]
Suprapubic Pain
  • We describe a case of a 26-year man with complaints of suprapubic pain and burning micturition for two weeks and intermittent hematuria for two months. On physical examination, there was palpable mobile pelvic mass measuring 10x10 cm.[ncbi.nlm.nih.gov]
Heart Failure
  • However, this is a case of right heart failure due to cardiac metastasis from a yolk sac tumor.[ncbi.nlm.nih.gov]
  • Ventricular involvement may cause heart failure due to systolic or diastolic dysfunction. Left atrial involvement may cause thrombi that facilitate distant metastasis and cause an ischemic lesion in the systemic arterial system.[exp-oncology.com.ua]
Left Ventricular Dysfunction
  • However, she also suffered from severe non-hematological toxicities, including grade 3 left ventricular dysfunction and grade 4 pulmonary fibrosis.[ncbi.nlm.nih.gov]
Jaundice
  • We describe an 11-month-old girl with a YST arising from the CBD who presented with obstructive jaundice.[ncbi.nlm.nih.gov]
  • The primary yolk sac tumor of the liver usually presents with abdominal pain, an abdominal lump, and less frequently, jaundice. The serum AFP is usually highly increased in these tumors.[journals.lww.com]
  • A previously healthy 20-year-old man, consulted to the emergency department for two days of emesis and abdominal pain associated with jaundice. On physical exam, the patient was stable, conscious and icteric.[omicsonline.org]
  • There was no jaundice and lymphadenopathy. Systemic examination was unremarkable. A lump was palpable in right lower abdomen. It was soft to firm, tender and 16-20 weeks uterine size.[turkjpath.org]
Subcutaneous Nodule
  • We report a case of an 11-month-old female with sacrococcygeal extragonadal yolk sac tumor manifesting as a draining subcutaneous nodule after initial treatment as an abscess.[ncbi.nlm.nih.gov]
Headache
  • A 55-year-old man with progressive left side weakness, headache, dizziness and ataxia, underwent preoperative magnetic resonance imaging, diffusion-weighted imaging and proton magnetic resonance spectroscopy.[ncbi.nlm.nih.gov]
  • When symptoms do occur, they may include the following: Nausea Vomiting Headache Cough Fever Changes in bowel function or habits Fatigue Problems with breathing Weight loss Night sweats Symptoms for location-specific endodermal sinus tumor may include[stjude.org]
  • Tumors in the pineal region of the brain can cause these symptoms: Increased fluid in the brain (hydrocephalus) Headache Vomiting Fatigue Feeling irritable Double vision Trouble looking up or focusing on close objects Coordination and balance issues Tumors[stjude.org]
Testicular Mass
  • MRI Heterogeneous testicular mass lesion with post-contrast heterogeneous enhancement, with areas of hemorrhage/necrosis 2.[radiopaedia.org]
  • No specific symptoms except testicular mass are present. Almost all the patients with a yolk sac tumor (YST), either in pure form or mixed form have a significantly elevated serum alpha fetoprotein (AFP).[emedicine.medscape.com]
  • On the second day in intensive care unit, physical examination revealed a large right testicular mass, not painful on palpation.[omicsonline.org]
Adnexal Mass
  • The patients were 23, 29, and 43 years old, and all presented with large unilateral adnexal masses confined to the ovary. One tumor was predominantly cystic, and the other 2 had prominent cystic components; all 3 also had solid components.[ncbi.nlm.nih.gov]
  • Fine needle aspiration (FNA) was performed from the right adnexal mass and peritoneum using a 22-G needle.[biocoreopen.org]
  • US characterizes the adnexal mass and shows ascites or hepatic metastasis. CT scan detects carcinosis and adenopathy, MRI reveals the hyper-vascularized and hemorrhagic feature of the mass ( 36 ).[frontiersin.org]
Pelvic Pain
  • CASE REPORT: A 44-year-old woman presented with 6 months of pelvic pain associated with a sensation of progressive mass growth.[ncbi.nlm.nih.gov]
  • Methods A 26-year-old man was admitted with a history of urinary urgency, hematuria, hematochezia, and pelvic pain.[academic.oup.com]
Oliguria
  • Chemotherapy with BEP was started, and after 24 h of administration, oliguria and tumor lysis syndrome (TLS) developed.[ncbi.nlm.nih.gov]
Burning Micturition
  • We describe a case of a 26-year man with complaints of suprapubic pain and burning micturition for two weeks and intermittent hematuria for two months. On physical examination, there was palpable mobile pelvic mass measuring 10x10 cm.[ncbi.nlm.nih.gov]

Workup

  • CONCLUSIONS This unique presentation of a yolk sac tumor emphasizes the need to keep a broad differential and complete a thorough workup for any cardiac mass.[ncbi.nlm.nih.gov]
  • AFP No discussion (or diagnostic workup) of yolk sac tumor is complete without considering alpha-fetoprotein (AFP). AFP is a protein produced predominantly by the yolk sac and fetal liver.[pathologystudent.com]
  • His symptom was caused by a ruptured massive intraabdominal tumor into the pleural space, which was identified during radiological workup.[jscimedcentral.com]
Gastric Lesion
  • The patient was diagnosed with gastric YST with synchronous liver metastasis and underwent simultaneous resection of the primary gastric lesion and liver metastasis successfully.[tcr.amegroups.com]

Treatment

  • Before the late 1970s, when innovative chemo treatments began, endodermal sinus tumor was almost always fatal. Without treatment, it spreads quickly in children and will lead to death.[stjude.org]
  • With this salvage treatment, she remained in complete remission and disease-free for more than 30 months, while maintaining her reproductive function.[ncbi.nlm.nih.gov]
  • In cases of advanced YST with unresectable residual disease, AFP levels combined with FDG-PET/CT scans may be a helpful way to monitor treatment response and assist in treatment planning for a disease that primarily affects young women who may desire[ncbi.nlm.nih.gov]
  • OBJECTIVE: The aim of the study was to identify the role of neoadjuvant chemotherapy (NACT) in the treatment of the patients with advanced stage ovarian yolk sac tumor (OYST).[ncbi.nlm.nih.gov]
  • This paper discusses the optimal treatment for testicular yolk sac tumor at stage I in children.[ncbi.nlm.nih.gov]

Prognosis

  • Postmenopausal patients with ovarian YST may have a worse prognosis compared to young patients.[ncbi.nlm.nih.gov]
  • Postmenopausal ovarian YSTs are aggressive, and may have a worse prognosis compared with those in young patients. More aggressive treatment is needed.[ncbi.nlm.nih.gov]
  • Extensive debulking surgery to minimize residual tumor would improve the prognosis.[ncbi.nlm.nih.gov]
  • It has been suggested that this rare tumor represents an adenocarcinoma with aberrant differentiation because it occurs in the same age range as epithelial ovarian carcinoma and shows an aggressive behavior and poor prognosis.[ncbi.nlm.nih.gov]
  • Primary YST occurring in the cerebellum is exceedingly rare, associated with a very poor prognosis and has been reported in less than 10 cases in literature.[ncbi.nlm.nih.gov]

Etiology

  • We review the previous literature and discuss the etiology, histology, treatment, and the prognosis of the rare sinonasal yolk sac tumor.[ncbi.nlm.nih.gov]
  • Albeit an uncommon etiology for heart failure, germ cell tumors can potentially metastasize to the heart and present with such a clinical picture.[ncbi.nlm.nih.gov]
  • Etiology Totipotent cells, which later form extraembryonic fetal membranes, give rise to yolk sac tumors. Features Perivascular structures called Schiller-Duval bodies can be found in 50% of tumors and are pathognomonic.[radiopaedia.org]
  • Rosenberg SA (eds): AIDS: Etiology, Diagnosis. Treatment, and Prevention. ‏ الصفحة 190 - Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. ‏ الصفحة 193 - Henson D, Tarone R.[books.google.com]
  • Etiology The etiology of yolk sac tumors (YSTs) is essentially unknown.[emedicine.medscape.com]

Epidemiology

  • Diagnostic criteria and microbial and epidemiologic associations. Am J Med. ‏ الصفحة 193 - Henson D, Tarone R. An epidemiologic study of cancer of the cervix, vagina, and vulva based on the Third National Cancer Survey in the United States.[books.google.com]
  • Epidemiology Yolk sac tumors (YSTs) can be seen in males and females, involving the testis, ovary, and other sites, such as the mediastinum.[emedicine.medscape.com]
  • Epidemiology Age: six months to five years, peak in boys of age less than 2 years LOH 6q21-26 LOH ( 11753688 ) 1p36 LOH (1p36 deletion) ( 11753688 ) Pathogenesis Hypermethylation of the RUNX3 gene promoter.[humpath.com]
  • Hepatocellular Carcinoma: Epidemiology, Risk Factors, and Screening. Medscape, from Semin Liver Dis . 2005;25(2):143-154 [On-line information]. Available online at . (2005 January 05). LBA AFP-L3. Wako [On-line package insert].[labtestsonline.it]
Sex distribution
Age distribution

Prevention

  • […] tumor was to identify putative pathways that are known to pose a block in differentiation, both in early embryogenesis and in tumorigenesis, that might be amenable to low toxicity therapies designed to promote differentiation to a more benign state and prevent[ncbi.nlm.nih.gov]
  • Treatment, and Prevention. ‏ الصفحة 190 - Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. ‏ الصفحة 193 - Henson D, Tarone R.[books.google.com]
  • Surgery alone has been unsuccessful in preventing recurrences even in stage 1 disease.[indianjcancer.com]
  • The research results in Erlangen set new standards in the prevention, diagnosis and tre Diagnostics of ovarian yolk sac tumor Chemotherapy of ovarian yolk sac tumor (1 course) Surgery treatment of ovarian yolk sac tumor University Hospital Halle (Saale[bookinghealth.com]
  • Postoperative chemotherapy (PEB) should be used to prevent recurrence in the ipsilateral or contralateral testis.[wjso.biomedcentral.com]

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