A Primary Pure Yolk Sac Tumor of the Lung Exhibiting CDX-2 Immunoreactivity and Increased Serum Levels of Alkaline Phosphatase Intestinal Isoenzyme

Abstract

Malignant extragonadal germ cell tumors primary to the lung are quite uncommon lesions, but pure yolk sac tumor is even more exceptional. This is believed to be the first reported case of yolk sac tumor of the lung in which an intense and diffuse immunoreactivity for CDX2, a marker of intestinal differentiation reportedly expressed also in gonadal yolk sac tumor, was associated with increased serum levels of the alkaline phosphatase intestinal isoform. Nine months after radical surgery and adjuvant chemotherapy, the patient is alive and well without evidence of recurrent or metastatic disease and with serum levels of the alkaline phosphatase intestinal isoform within normal limits. The pathologist should be aware of yolk sac tumor arising in the lung and that alkaline phosphatase intestinal isoform could become an additional serum marker for such a tumor.

A bilateral primary yolk sac tumor of the lung associated with chromosome 3 polysomy

“…Pelosi and colleagues in their reported case of a pure yolk sac tumor of the lung showed that the tumor had diffuse Cdx2 immunoreactivity. 7 Our case was completely negative for Cdx2 but showed diffuse Oct3/4 immunostaining. Oct-4 is an accepted marker for identifying germ cell origin (ie, seminoma or embryonal carcinoma) in the work-up of an undifferentiated neoplasm.…”

Case report of death from falling: Did heart tumor cause syncope?

“…We therefore diagnosed primary lung YST with metastatic intracardiac YST. Primary lung YST is very rare and only few cases have ever been reported [2][3][4][5][6][7].…”

Large mixed germ cell tumor in a young patient presenting as an intrapulmonary mass

“…However, since the patient's relatives refused an autopsy, this could not be definitely excluded. Primary intrapulmonary germ cell tumors are quite rare, and only few chorioncarcinomas, yolk sac tumors, embryonic carcinomas, and very few mixed GCTs have been reported [10,13,20,[24][25][26]33]. Macroscopically, most mixed germ cell tumors were poorly circumscribed and showed an invasive growth pattern [32].…”