Primary Yolk Sac Tumor in the Cerebellar Hemisphere: A Case Report and Literature Review of the Rare Tumor.

Meng Chen,Na Wu,Yimin Xie,Shulei Peng,Taotao Zhang,Song Duan,Wen Zhong,Jinbo Ning,Qiang Chen,Chongjie Cheng

doi:10.3389/fonc.2021.739733

Abstract

Yolk sac tumor (YST) is one of rare malignant germ cell tumors (GCTs). Primary intracranial YST, also endodermal sinus tumor (EST), is a quite rare type of brain tumor. Here, we report a case of YST, review the relevant literature, and propose a treatment strategy for this rare tumor. A 6-year-old boy initially manifested symptoms of dizziness and vomiting. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large irregular oval tumor in the cerebellar hemisphere. We subtotally removed the tumor by microsurgery through the left suboccipital approach. Immunohistochemical staining showed that alpha fetoprotein (AFP) was positive and the Ki-67 proliferation index was high (60%), suggesting a germ cell tumor. After 3 months of follow-up, neither recurrence of tumor nor complications were found in the patient. The diagnosis of YST should be confirmed on the basis of clinical manifestations, neuroimaging and pathological findings. Gross total resection (GTR) is an ideal treatment for YST. However, due to the location of the tumor, GTR is usually difficult, and the rate of postoperative complications is high. This reported case shows that subtotal resection can be a good treatment strategy for YST.

Highlights

Yolk sac tumor (YST), known as endodermal sinus tumor (EST), is a rare central nervous system neoplasm because of the similarity of this tumor to the endodermal sinuses of the rat placenta described by Duval [1]
We report a case of YST in a patient who presented with dizziness and vomiting and review the diagnostic criteria and treatment strategies of this rare neural tumor
Yolk sac tumor (YST) is a rare malignant germ cell tumor (GCT) that usually originate from the gonad but is rarely observed extragonadally [15]

Summary

BACKGROUND

Yolk sac tumor (YST), known as endodermal sinus tumor (EST), is a rare central nervous system neoplasm because of the similarity of this tumor to the endodermal sinuses of the rat placenta described by Duval [1]. Primary intracranial YSTs usually involve the pineal or suprasellar regions. Primary YST in the posterior fossa is extremely rare [2, 3]. Only a few cases of primary YST were confined to the posterior fossa [2,3,4,5,6,7,8,9,10,11,12,13,14] (Table 1). We report a case of YST in a patient who presented with dizziness and vomiting and review the diagnostic criteria and treatment strategies of this rare neural tumor

Unknown Cerebellar hemisphere

Findings

DISCUSSION