Journal of Pathology and Translational Medicine

Case Studies

A sinonasal yolk sac tumor in an adult: Jaehoon Shin, Ji Heui Kim, Kyeong Cheon Jung, Kyung-Ja Cho; J Pathol Transl Med. 2022;56(3):152-156. Published online January 26, 2022; DOI: https://doi.org/10.4132/jptm.2021.12.09

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Yolk sac tumors (YSTs), which are also called endodermal sinus tumors, are malignant tumors of germ cell origin. These tumors usually occur in the gonads, but 20% of cases have been reported at extragonadal sites. The head and neck is a rarely affected region that accounts for just 1% of all malignant tumors of germ cell origin. In addition, YSTs arise mostly in childhood. We present a rare pathologically pure case of primary adult YST in the sinonasal area. A 45-year-old male patient presented with a rapidly growing mass in the nasal cavity, which caused nasal obstruction and bloody post-nasal drip. The histopathologic features indicated pure YST, and immunohistochemical analysis revealed positive reactivity for Sal-like protein 4 and alpha-fetoprotein. Herein, we discuss the clinical, radiologic, and histologic features of this YST and review other cases of sinonasal YST in adults.

Citations

Citations to this article as recorded by

SMARCB1-deficient Sinonasal Carcinoma
Neha Mittal, Saurabh Nagar, Asawari Patil, Swapnil Ulhas Rane, Palgun Nisarga, Katha Rabade, Amit Janu, Deepa Nair, Shiva Thiagarajan, Sarbani Ghosh Laskar, Kumar Prabhash, Munita Bal
American Journal of Surgical Pathology.2025; 49(4): 381. CrossRef
International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors
Edward C. Kuan, Eric W. Wang, Nithin D. Adappa, Daniel M. Beswick, Nyall R. London, Shirley Y. Su, Marilene B. Wang, Waleed M. Abuzeid, Borislav Alexiev, Jeremiah A. Alt, Paolo Antognoni, Michelle Alonso‐Basanta, Pete S. Batra, Mihir Bhayani, Diana Bell,
International Forum of Allergy & Rhinology.2024; 14(2): 149. CrossRef
Yolk sac tumor of postpubertal-type does not exhibit immunohistochemical loss of SMARCB1/INI1 and SMARCA4/BRG1…but choriocarcinoma?
Costantino Ricci, Francesca Ambrosi, Tania Franceschini, Francesca Giunchi, Eugenia Franchini, Francesco Massari, Veronica Mollica, Federico Mineo Bianchi, Maurizio Colecchia, Andres Martin Acosta, Michelangelo Fiorentino
Pathology - Research and Practice.2023; 241: 154269. CrossRef
Pure yolk sac tumor primarily in the nasal cavity: A case report
Zijun Liu, Baohong Wen, Yan Zhang
Asian Journal of Surgery.2023; 46(10): 4712. CrossRef
A case of Yolk sac tumor arising from paranasal sinus
Kaori Shinomura, Munehito Moriyama, Keigo Fujita, Takashi Hirano, Masashi Suzuki
JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY.2023; 33(1): 41. CrossRef
A Novel Successful Case of Nasal and Sinus Yolk Sac Tumor With SMARCB1 (INI-1) Deficiency: A Case Report
Tianyu He, Zhiyu Wang, Hongbo Su, Sihan Li, Zheng He
Cureus.2022;[Epub] CrossRef

Primary hepatic mixed germ cell tumor in an adult: Hyun-Jung Sung, Jihun Kim, Kyu-rae Kim, Shinkyo Yoon, Jae Hoon Lee, Hyo Jeong Kang; J Pathol Transl Med. 2021;55(5):355-359. Published online August 3, 2021; DOI: https://doi.org/10.4132/jptm.2021.06.16

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Primary hepatic mixed germ cell tumor (GCT) is very rare, and less than 10 cases have been reported. We report a case of mixed GCT composed of a choriocarcinoma and yolk sac tumor, which occurred in the liver of a 40-year-old woman. A large mass was detected by computed tomography solely in the liver. Serum β-human chorionic gonadotropin (hCG) was highly elevated, otherwise, other serum tumor markers were slightly elevated or within normal limits. For hepatic choriocarcinoma, neoadjuvant chemotherapy was administered, followed by right lobectomy. Histologic features of the resected tumor revealed characteristic choriocarcinoma features with diffuse positivity for hCG in the syncytiotrophoblasts and diffuse positivity for α-fetoprotein and Sal-like protein 4 in the yolk sac tumor components. Primary malignant GCT in the liver is associated with a poor prognosis and requires specific treatment. Therefore, GCT should be considered during a differential diagnosis of a rapidly growing mass in the liver.

Citations

Citations to this article as recorded by

Mesenchymal Tumors of the Liver: An Update Review
Joon Hyuk Choi, Swan N. Thung
Biomedicines.2025; 13(2): 479. CrossRef
Testicular Seminoma in Prostate: Case Report and Review of Literature
Peter Lesko, Jana Obertova, Karol Kajo, Katarina Rejlekova, Zuzana Orszaghova, Viera Lehotska, Martina Ondrusova, Michal Chovanec, Dalibor Ondrus, Michal Mego
Clinical Genitourinary Cancer.2024; 22(2): 210. CrossRef

Case Reports

Ovarian Endometrioid Adenocarcinoma with a Yolk Sac Tumor Component.: Dong Hae Chung, Sanghui Park, Hee Eun Kyung, Na Rae Kim, Seung Yeon Ha, Soyi Lim, Hyun Yee Cho; Korean J Pathol. 2009;43(6):570-574.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.570

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Abstract PDF: Ovarian endometrioid adenocarcinoma (EAC) with a yolk sac tumor (YST) component is extremely rare. Only twelve cases have been reported in the English literature. We report here two additional cases of this rare tumor. The YST component showed classic microscopic features, and immunohistochemically stained positive for alpha-fetoprotein (AFP), but negative for cytokeratin 7 (CK7), epithelial membrane antigen (EMA), estrogen receptor (ER) and progesterone receptor (PR). The EAC appeared to blend into the YST in several areas and immunohistochemically stained positive for CK7, EMA, ER, and PR, but negative for AFP.

Diffuse Embryoma of the Testis: A Case Report.: Won Ae Lee; Korean J Pathol. 2008;42(2):103-107.

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Abstract PDF: Diffuse embryoma of the testis is a very rare, distinct form of mixed germ cell tumor. I report here on a case of diffuse embryoma in a 22-year-old male who presented with painful scrotal swelling. The resected testis was entirely occupied by a non-encapsulated tumor mass. The cut surface of the tumor was grey or whitish pink, soft and granular with foci of hemorrhage and necrosis. Microscopically, the tumor was characterized by a diffuse, orderly arrangement of embryonal carcinoma and yolk sac tumor in almost equal proportions. The yolk sac tumor component was diffusely wrapped around the embryonal carcinoma. Syncytiotrophoblasts were scattered throughout the tumor. Minor foci of immature teratoma, seminoma and intratubular germ cell neoplasia were observed. The yolk sac tumor (YST) component was emphasized by immunoreactivity for alpha fetoprotein, whereas the embryonal carcinoma was reactive for CD30. The strong reactivity for cytokeratin in the YST component formed an outstanding contrast to the weak cytokeratin reactivity in the embryonal carcinoma.

Adenocarcinoma with Yolk Sac Tumor of the Stomach: Case Report with Review of the Literature and an Immunohistochemical Study.: Ran Hong, Chae Hong Suh, Mi Ja Lee; Korean J Pathol. 2007;41(5):352-357.

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Abstract PDF: Gastric yolk sac tumors are extremely rare with only a few cases reported in the literature. Here, we present the case of a 50-year-old man with an adenocarcinoma and a yolk sac tumor of the stomach, without metastasis to the lymph nodes. The tumor was an early gastric carcinoma confined to the submucosa. Twelve months post-operation the patient was alive with no complications. The yolk sac tumor showed positive labeling for alpha-fetoprotein (AFP), alpha1-antitrypsin (alpha1-AT), cytokeratin (CK) and carcinoembryonic antigen (CEA), but was negative for human chorionic gonadotrophin (hCG), placental alkaline phosphatase (PLAP), epithelial membrane antigen (EMA) and p53. The adenocarcinoma was positive for alpha1-AT, CK, EMA, and CEA, but was negative for AFP, hCG, PLAP, and p53. These findings suggest that the yolk sac tumor and the adenocarcinoma components are closely related and may represent distinct phenotypes that arise from a common mucosal epithelial cell.

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