Spinal cord compression of primary extragonadal giant yolk sac tumor

Abstract

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.

Extragonadal Yolk Sac Tumor with Spinal Cord Compression in a Little Boy, with Complete Response to the Bleomycin, Etoposide, and Carboplatin: A Case Report and Review of the Literature

“…Both abdominal computed tomography scan (CT-scan) and lumbar magnetic resonance imaging (MRI) are the preferred radiological examinations in the diagnosis of these types of tumors (4). Histologic examination of the surgical specimen confirmed the definitive diagnosis of YST.…”

“…There are very rare cases of the primary retroperitoneal tumor with spinal column invasion and cord compression and most of these cases are observed in children (4,5).…”

Diagnostic and therapeutic challenges in extragonadal yolk sac tumor with hepatoid differentiation: A case report

“…YSTs arise most commonly in the gonads, but extragonadal sites of origin are reported in 24% of the cases (11). The most common localization of YST is the anterior mediastinum, followed by the retroperitoneum and cranium (2,3); exceedingly rare sites, such as the lungs, pancreas, kidney and spinal cord, have also been reported (12)(13)(14)(15). Regarding the intracranial manifestations, YSTs are typically located midline in the pineal region or the suprasellar region (3).…”

Extragonadal germ cell tumor presenting with spinal cord compression: a case report and literature review

“…Systemic EST has occasionally been reported to metastasize to the spine [3]. There are few previously reported cases of EST in children and adults presenting with spinal cord compression [2,3,[5][6][7]. In this article, we report a 28-monthold boy with primary EST located in the retroperitoneal region presenting with thoracic spinal cord compression.…”

“…Yolk sac tumor or endodermal sinus tumor (EST) primarily originates from the testes or the ovaries. In 2-5% of cases, it originates from extragonadal sites involving posterior midline structures in the mediastinal, retroperitoneal, and sacrococcygeal areas and intracranially in the suprasellar and pineal regions [2,3]. Gonadal sites predominate in children older than 3 years old and adolescents, while extragonadal tumors are more common in neonates and infants [4].…”