Mixed Germ Cell Tumor with Extensive Yolk Sac Tumor Elements in the Frontal Lobe of an Adult

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.

Mixed Germ Cell Tumor with a Yolk Sac Tumor Component in the Medulla Oblongata of a 50-year-old Patient: A Case Report and Literature Review

“…In most cases, the onset of YST occurs in childhood and young adulthood. In the relevant English literature, there are only 5 reported cases of YST in patients over 35 years old ( Table 1 ) ( 23 - 27 ). Our case represents the fourth-oldest patient with adult-onset yolk sac tumor reported worldwide.…”

“…There have been 24 cases of germinoma of the medulla oblongata and the fourth ventricle reported in the literature ( Table 2 ). Eighteen of these cases were reported from East Asian countries (Japan, n=11; Taiwan, n=3; China, n=3; Thailand, n=1) ( 3 - 7 , 9 - 11 , 13 , 15 - 18 , 20 , 23 ). Sixteen of the 24 cases were women, and 2 cases were men with Klinefelter syndrome (chromosomal karyotype: 47, XXY).…”

A Case of Non-Germinomatous Germ Cell Tumors of the Frontal Lobe Arising From the Lateral Ventricle With a Synchronous Pineal Lesion

“…Our findings were similar to those reported in the literature and suggested a diagnosis of germ cell tumour. Takahashi et al have reported a case of an NGGCT with a frontal lobe lesion [ 6 ]. Often these synchronous lesions with a background of detectable b-HCG and normal to mildly raised AFP are empirically diagnosed as germinomatous germ cell tumours [ 7 ].…”

Diagnostic and therapeutic challenges in extragonadal yolk sac tumor with hepatoid differentiation: A case report

“…Regarding the intracranial manifestations, YSTs are typically located midline in the pineal region or the suprasellar region (3). One case of mixed GCT with extensive yolk sac elements outside the midline (in the frontal lobe) in an adult was also reported (16).…”