Abstract
BackgroundPediatric germ cell tumors account for approximately 3.5 % of all childhood cancers for children under the age of 15 years. Up to one-third are extragonadal neoplasms. Germ cell tumors are a heterogeneous group of malignant tumors with a wide variety of histopathological features. Yolk sac tumor is the predominant variant in newborns and younger children. We report for the first time, the presentation of a primary yolk sac tumor in the abdominal wall of a small child.Case presentationAn 18-month-old white girl underwent resection of a small, round subcutaneous lump (1.5×1.3×0.8 cm) of the abdominal wall in her right hypochondriac region. The histopathology was compatible with yolk sac tumor. Her alpha-fetoprotein was initially elevated but normalized after the resection. Magnetic resonance imaging of her abdomen was normal. The surgeon decided to observe and follow her alpha-fetoprotein level closely. One year after resection a local recurrence appeared and her alpha-fetoprotein rose to 58 ng/mL. The surgeon performed a wide resection of the lesion with normalization of her alpha-fetoprotein. Follow-up consisted of measuring alpha-fetoprotein, clinical evaluation, and abdominal ultrasound.ConclusionsClinicians should be aware that a yolk sac tumor can present in an unusual extragonadal place, for example in this case it was subcutaneous. In some cases, conservative treatment can be carried out with careful monitoring of the patient and their alpha-fetoprotein.
Highlights
Pediatric germ cell tumors account for approximately 3.5 % of all childhood cancers for children under the age of 15 years
Clinicians should be aware that a yolk sac tumor can present in an unusual extragonadal place, for example in this case it was subcutaneous
The only known risk factor for extragonadal germ cell tumors (GCTs) is the presence of Klinefelter syndrome (47,XXY karyotype)
Summary
We describe the first report of an 18-month-old girl diagnosed with a yolk sac tumor subcutaneously. A year after resection, she presented with local recurrence, which was treated with a wide resection only. Five years of follow-up did not reveal signs of local recurrence or distant disease. It is important that clinicians are aware that yolk sac tumor can present in an unusual extragonadal place. Conservative treatment can be carried out with careful monitoring of the patient and their αFP
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