A Rare Case of Primary Anterior Mediastinal Yolk Sac Tumor in an Elderly Adult Male

Abstract

Mediastinal germ cell tumors are extragonadal germ cell tumors (EGGCTs) commonly seen in children and young adults. They are more common in men. Clinically they are classified as teratomas, seminomas, and nonseminomatous germ cell tumors. Primary mediastinal yolk sac neoplasm is an extremely rare tumor. We present here a very rare case of primary yolk sac tumor of the anterior mediastinum in a 73-year-old male. Mediastinal germ cell tumors have a worse prognosis than gonadal germ cell tumors. Chemotherapy followed by adjuvant surgery improves overall response in EGGCTs. However, comorbidities can render treatment with chemotherapy and surgery challenging in elderly patients.

Yolk sac primary tumor of mediastino: a rare case in a young adult

“…Some clinical conditions are associated with yolk sac tumor, according to literature, such as Klinefelter syndrome (around 20% of cases), precocity of pubertal development and hematological neoplasia, such as leukemia and myelodysplastic syndrome. 2 , 8 , 9 …”

“…In yolk sac tumor, alpha-fetoprotein is elevated, and in some cases carcinoembrionary antigen can also be elevated. 8 Alpha-fetoprotein serum levels are useful for diagnosis, and, mainly, in the follow-up of this tumor, therefore showing if there is or not a response to treatment.…”

A Rare Case of Primary Mediastinal Endodermal Sinus Tumor Presenting with Hemoptysis

“…Prognosis of germ cell tumors is based upon AFP levels, location, metastatic diseases, and the ability to have complete surgical resection [6]. Patients with a primary mediastinal focus are deemed to have a poor prognosis just based on location alone, giving them a five-year survival rate of 40-50% and a six-month survival rate following relapse [3,7].…”

Consideraciones en torno a los tumores del mediastino

“…No son infrecuentes los linfomas, las afecciones tumorales de las glándulas tiroides y paratiroides, los teratodermoides, el carcinoma primario del mediastino, los tumores de células germinales, los hamartomas, plasmocitomas y tumores de origen linfático, principalmente en la parte anterior (representan alrededor de 17 %). Allí los más comunes son los linfomas de Hodgkin, variedad esclerosis nodular, que son de mejor pronóstico; mientras los linfomas no Hodgkin, con una presentación clínica similar, son de evolución agresiva y mala pronóstico [33][34][35][36] .…”

“…En los tumores neurógenos puede producirse la afección medular por compresión, pero es rara. Por último, en el síndrome de Tobias-Pancoast son frecuentes las braquialgias por invasión del plexo braquial 17,32,36,37 .…”