Coexistence of Glomangioma and Yolk Sac Tumour in a Child: A Case Report

Abstract

Glomus tumours (GTs) primarily arise from glomus bodies that are located in the dermis layer of skin. However, they can be encountered ectopically in most parts of the body. As a result of researches done in a 17-month-old male patient who prssented to us with complaint of an increasingly growing swelling, he was diagnosed with a yolk sac tumour. Chemotherapy was started and then, he was operated. GT was found inside the tumoural mass. Our patient, who is the first case according to our knowledge, where the concurrence of yolk sac and glomus tumours was reported, has been discussed in the light of literature. CASE REPORTA 17-month-old male patient presented to our hospital with complaint of swelling in hip and inability in sitting. Swelling had occurred about one month ago, it had enlarged increasingly and it had became a condition that prevented him from sitting. During his physical examination, a mass was identified in the sacrococcygeal region. During magnetic resonance imaging (MRI) studies which were done, the mass was seen to invade into the gluteal muscle, posterior to the rectum and it was reported as a teratoma. In thoracic tomogram, a nodular image which was compatible with metastasis in the lower lobe of the right lung was seen. Alpha fetoprotein was 68309 ng/mL.It was diagnosed as a yolk sac tumour during a histopathologic investigation of the material which was done, which was received by doing a tru-cut biopsy. The patient was discharged after 3 he took courses of BEP (Bleomycin, Etoposide, Cisplatin) treatment . A post-operative tumoural mass necrosis and the presence of a GT inside this mass were identified. In the histopathologic examination, glomus tumour was found to consist of uniform, round or oval cells with round or oval nuclei and pale eosinophilic cytoplasm. Tumour cells were arranged in sheets or nests patterns, and they were found to surround vessels. The tumour cells were stained by PAS and they were diffusely positive for SMA [Table/ Fig-1]. The MIB-1 index was about 1-2%. Glomus tumour was diagnosed on the basis of these features. Chemotherapy of the patient was continued. The patient is still being followed up by us without any problem.