Primary endodermal sinus (yolk sac) tumour of the liver

Gunawardena, Sharmini; Siriwardana, H. P. Priyantha; Wickramasinghe, S.Y.L.S.; Madurawe, M.N.; Fernando, Ruchira

doi:10.1053/ejso.2001.1187

Cited by 18 publications

(21 citation statements)

References 5 publications

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“…Primary extragonadal germ cell tumors are uncommon tumors that most often occur in the midline structures and mediastinum, but they can also occur in many other organs, not only in children but also in adults. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Morphologically, primary extragonadal germ cell tumors can mimic many types of non-germ cell tumors. For example, mediastinal seminomas may mimic type B thymomas and embryonal carcinoma may mimic other types of carcinomas.…”

Section: Discussionmentioning

confidence: 99%

“…The yolk sac tumor is the extragonadal germ cell tumor that poses the greatest diagnostic challenges because of its multiple histological patterns and wide organ distribution. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Previous markers for diagnosing extragonadal yolk sac tumors included placental-like alkaline phosphatase, a-fetoprotein, and glypican-3, but they lack adequate sensitivity and specificity. Recent studies have shown that SALL4 is a more sensitive marker for primary extragonadal yolk sac tumors.…”

Section: Discussionmentioning

confidence: 99%

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RNA-binding protein LIN28 is a marker for primary extragonadal germ cell tumors: an immunohistochemical study of 131 cases

et al. 2011

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LIN28 has been shown to have an important role in primordial germ cell development and malignant transformation of germ cells in mouse. In this study, we examined the immunohistochemical profile of LIN28 in 131 primary human extragonadal germ cell tumors (central nervous system (CNS) 76, mediastinum 17, sacrococcygeal region 30, pelvis 3, vagina 2, liver 1, omentum 1, and retroperitoneum 1), including the following tumors and/or components: 57 seminomas/germinomas, 10 embryonal carcinomas, 74 yolk sac tumors, 6 choriocarcinomas, 15 mature, and 13 immature teratomas. We compared LIN28 with SALL4 to assess its diagnostic value. To determine its specificity, we examined LIN28 in 406 extragonadal-non-germ cell tumors (103 carcinomas, 91 sarcomas, 9 melanomas, 12 mesotheliomas, 83 lymphomas, 9 plasmacytomas, 82 CNS tumors, and 17 thymic epithelial tumors). The staining was semi-quantitatively scored as 0 (no cell stained), 1 þ (0-30%), 2 þ (31-60%), 3 þ (61-90%), and 4 þ (490%). LIN28 staining was seen in all seminomas/germinomas (3 þ in 1 and 4 þ in 56), embryonal carcinomas (4 þ in all 10), and yolk sac tumors (3 þ in 3 and 4 þ in 71). Variable LIN28 staining was seen in 5 of 6 choriocarcinomas (1 þ to 4 þ ), 8 of 13 immature teratomas (1 þ to 2 þ in immature elements), and in 1 of 15 mature teratomas (1 þ ). Only 11 of 406 non-germ cell tumors showed 1 þ LIN28 staining. Therefore, LIN28 is a sensitive (100% sensitivity) marker for primary extragonadal seminomas/germinomas, embryonal carcinomas, and yolk sac tumors with high specificity. Compared with SALL4, LIN28 demonstrated a similar level of diagnostic sensitivity for seminomas/ germinomas and embryonal carcinomas. For primary extragonadal yolk sac tumors, although SALL4 stained all tumors (1 þ in 1, 2 þ in 2, 3 þ in 10, and 4 þ in 61), LIN28 stained more tumor cells (mean 95 vs 90%, P ¼ 0.03) and was therefore more sensitive. For primary extragonadal yolk sac tumors, combining LIN28 and SALL4 can achieve a higher diagnostic sensitivity than either alone.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

RNA-binding protein LIN28 is a marker for primary extragonadal germ cell tumors: an immunohistochemical study of 131 cases

et al. 2011

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“…Similar elevations of serum AFP have been reported in cases of hepatic YST. 5,[7][8][9] The differential diagnosis for an elevated serum AFP includes hepatocellular carcinoma, hepatoblastoma, or a metastatic yolk sac malignancy. A markedly elevated AFP level in a pediatric patient should alert the cytopathologist to consider these diagnoses and to consider the possibility of a primary hepatic YST.…”

Section: Discussionmentioning

confidence: 99%

Cytomorphology of yolk sac tumor of the liver in fine-needle aspiration: A pediatric case

et al. 2006

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Yolk sac tumors (YST) in extragonadal locations are rare. Cytologic diagnosis of YST on fine-needle aspiration (FNA) smears may be a challenge to the cytopathologist. Further neo-adjuvant therapy may be based on cytologic diagnosis making accuracy important. We studied FNA material from a hepatic mass in a pediatric patient to further define the cytomorphologic features of hepatic YST. Features include large pleomorphic balls of tumor cells with high nuclear to cytoplasmic ratios, papillary or microglandular pattern of growth, cytoplasmic and intranuclear vacuoles, and prominent nucleoli. Positive immunohistochemical studies included alpha-fetoprotein, cytokeratin AE1/AE3, and CAM 5.2, which are useful in supporting the diagnosis. We report a pediatric patient in whom the diagnosis of hepatic YST was made by cytologic, histologic, and immunohistochemical studies. The subsequent liver biopsy was consistent with the FNA diagnosis. Our findings may further help to characterize the cytomorphologic features of this rare lesion.

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“…12 They may originate from gonads or from extragonadal organs and tissues. 1,8,9,11,[13][14][15][16][17][18] The exact pathogenesis of extragonadal germ cell tumors is unknown, but it has been suggested that the malignancy process starts during the early embryological days. The primordial cells located in the midline of the embryo are thought to be affected during this period and develop a malignant tumor later.…”

Section: Discussionmentioning

confidence: 99%

“…The primordial cells located in the midline of the embryo are thought to be affected during this period and develop a malignant tumor later. [13][14][15][16][17][18] Only two cases have been reported in the literature with metastasis to the spinal column and compression of the spinal cord. 10,19 However, we have not found in the literature any adult cases located in the retroperitoneum and presenting primarily with spinal cord compression.…”

Section: Discussionmentioning

confidence: 99%

Spinal cord compression of primary extragonadal giant yolk sac tumor

et al. 2006

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Study design: Case report. Objective: To report an adult male patient with a primary extragonadal giant yolk sac tumor presenting with acute spinal cord compression. Setting: Faculty of Medicine, University of Dicle, Diyarbakir, Turkey. Method: A 31-year-old man was referred to our department with a diagnosis of Pott's disease, a complaint of back pain and gait difficulty for 2 weeks. Neurological examination showed spastic paraparesis and hypoesthesia below the L2 dermatome level. He also had urinary incontinence. Abdominal computed tomography and lumbar magnetic resonance imaging study revealed a giant cystic mass lesion located in the psoas muscle. Posteriorly, the third lumbar vertebral body was destructed and the tumor was compressing the dural sac. A combined anterior and posterior approach was performed. Pathological diagnosis was a yolk sac tumor. Result: His neurological status improved during the postoperative course. A chemotherapy protocol was given including bleomycin, etoposide and cisplatin. Five months after the last chemotherapy, he was brought to the emergency unit in sepsis and died despite antibiotherapy. Conclusion: Yolk sac tumor should be considered in young adult male patients presenting with acute paraparesis even without any signs or medical history of a testis tumor. These tumors may be unresectable; however, decompression of neural structures and stabilization of the spine with instrumentation may cause substantial improvement in neurological deficit and pain relief.

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Primary endodermal sinus (yolk sac) tumour of the liver

Cited by 18 publications

References 5 publications

RNA-binding protein LIN28 is a marker for primary extragonadal germ cell tumors: an immunohistochemical study of 131 cases

RNA-binding protein LIN28 is a marker for primary extragonadal germ cell tumors: an immunohistochemical study of 131 cases

Cytomorphology of yolk sac tumor of the liver in fine-needle aspiration: A pediatric case

Spinal cord compression of primary extragonadal giant yolk sac tumor

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