Abstract
Tumors of germ cell origin are the most frequently diagnosed malignant neoplasms of the ovary and testis in infants and children. Although the more frequent adult histological subtypes, such as embryonal carcinoma and seminoma (dysgerminoma), do occur in the pediatric population, one subtype occurs almost exclusively in children. This is the endodermal sinus or yolk sac tumor (YST), so named by Teilum in 1959 because of the resemblance of this tumor to the endodermal sinuses of the rat placenta described by Duval (210). This tumor has been recognized at several extra-gonadal sites, including the presacral area, the anterior mediastinum and the pineal; and, with the exception of tumors originating in the testis, is associated with a poor prognosis. We will review the diagnosis and management of the YST, and will suggest areas where the use of aggressive combination chemotherapy may lead to improved survival of infants and children with this tumor.
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