Mixed germ cell tumor with extensive yolk sac tumor elements in the frontal lobe of an adult.

Toshihide Takahashi,Tetsuya Yamamoto,Yosuke Masuda,Taiki Sato,Makoto Shibuya,Akira Matsumura,Eiichi Ishikawa

doi:10.1155/2012/473790

Toshihide Takahashi, Tetsuya Yamamoto + Show 5 more

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https://doi.org/10.1155/2012/473790

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Abstract

Intracranial nongerminomatous germ cell tumors (NGGCTs) in unusual locations are extremely rare. Here, we report a case of a yolk sac tumor in the frontal lobe in a middle-aged patient. A 42-year-old man was admitted to our hospital for headache and nausea. Magnetic resonance imaging (MRI) showed an enhanced mass lesion with a marked cyst component. The serum alpha-fetoprotein (αFP) level was extremely high. Histological examination of specimens after subtotal removal revealed a primary mixed germ cell tumor with extensive yolk sac tumor elements, often referred to as an intracranial “yolk sac tumor.” The preoperative diagnosis of NGGCTs in unusual age and locations is extremely difficult. Clinicians should consider the possibility of NGGCTs, including yolk sac tumors, when intracranial tumors with unusual MRI findings are encountered.

Highlights

The authors retrospectively speculate that the tumor in the present case originated from the basal ganglia and extended into the frontal lobe
Detailed descriptions of intracranial yolk sac tumors in the frontal lobe or the basal ganglia have been published for only 7 cases, including our case [4–10]
In all of the previous cases, the tumors developed in patients no older than 18 years; the present case is the first report of a yolk sac tumor in this location in a middle-aged patient

Summary

Introduction

Nongerminomatous germ cell tumors (NGGCTs) of the central nervous system (CNS) are rare, accounting for fewer than 1% of primary brain tumors, and they occur predominantly in children or young adults [1, 2]. Twelve percent of NGGCTs are mixed germ cell tumors with yolk sac tumor elements, and 2% are pure yolk sac tumors [3]. Most NGGCTs, including yolk sac tumors, are located in pineal lesions or suprasellar lesions, and they rarely originate from basal ganglia and other lesions [3]. We report a case of a yolk sac tumor in the frontal lobe in a middle-aged patient

Case Report

Findings

Discussion