Yolk Sac Tumor in an Eight-Year-Old Girl: A Case Report and Literature Review

Chen, Li Hsun; Yip, Kui-Chuen; Wu, Hsing‐Ju; Yong, Su‐Boon

doi:10.3389/fped.2019.00169

Cited by 25 publications

(35 citation statements)

References 45 publications

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“…Simple YST is the most common form, mainly originating from the gonads (testes and ovaries), but other types of extragonadal YST can occur in the pelvis, sacral tail, and vagina. (21). The tumor locations of RMS and YSTs partially overlap, and these tumors have similar imaging manifestations, including larger solid tumors occupying the pelvis, with little calcification and hemorrhaging, abundant blood vessels in the AP, and progressive enhancement (21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

“…(21). The tumor locations of RMS and YSTs partially overlap, and these tumors have similar imaging manifestations, including larger solid tumors occupying the pelvis, with little calcification and hemorrhaging, abundant blood vessels in the AP, and progressive enhancement (21)(22)(23). Although some studies have summarized imaging features of RMS, its manifestations still lack specificity (4,20).…”

Section: Discussionmentioning

confidence: 99%

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CT-Based Radiomics to Differentiate Pelvic Rhabdomyosarcoma From Yolk Sac Tumors in Children

Chen

Huang

et al. 2020

Front. Oncol.

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BackgroundThe purpose of this study was to investigate the role of CT radiomics features combined with a support vector machine (SVM) model in potentially differentiating pelvic rhabdomyosarcoma (RMS) from yolk sac tumors (YSTs) in children.MethodsA total of 94 patients with RMS (n = 49) and YSTs (n = 45) were enrolled. Non-enhanced phase (NP), arterial phase (AP), and venous phase (VP) images were retrieved for analysis. The volumes of interest (VOIs) were constructed by segmenting tumor regions on CT images to extract radiomics features. Datasets were randomly divided into two sets including a training set and a test set. In the training set, the least absolute shrinkage and selection operator (LASSO) algorithm was used to screen out the optimal radiomics features that could distinguish RMS from YSTs, and the features were combined with the SVM algorithm to build the classifier model. In the testing set, the areas under the receiver operating characteristic (ROC) curves (AUCs), accuracy, specificity, and sensitivity of the model were calculated to evaluate its diagnostic performance. The clinical factors (including age, sex, tumor site, tumor volume, AFP level) were collected.ResultsIn total, 1,321 features were extracted from the NP, AP, and VP images. The LASSO regression algorithm was used to screen out 23, 26, and 17 related features, respectively. Subsequently, to prevent model overfitting, the 10 features with optimal correlation coefficients were retained. The SVM classifier achieved good diagnostic performance. The AUCs of the NP, AP, and VP radiomics models were 0.937 (95% CI: 0.862, 0.978), 0.973 (95% CI: 0.913, 0.996), and 0.855 (95% CI: 0.762, 0.922) in the training set, respectively, which were confirmed in the test set by AUCs of 0.700 (95% CI: 0.328, 0.940), 0.800 (95% CI: 0.422, 0.979), and 0.750 (95% CI: 0.373, 0.962), respectively. The difference in sex, tumor volume, and AFP level were statistically significant (P < 0.05).ConclusionsThe CT-based radiomics model can be used to effectively distinguish RMS and YST, and combined with clinical features, which can improve diagnostic accuracy and increase the confidence of radiologists in the diagnosis of pelvic solid tumors in children.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

CT-Based Radiomics to Differentiate Pelvic Rhabdomyosarcoma From Yolk Sac Tumors in Children

Chen

Huang

et al. 2020

Front. Oncol.

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“…Ovarian cancer is responsible for 1-2% of all childhood malignancies, between 1-15 years of age. [12] Histologically, germ cell tumors account for 85% of neoplasia of the ovary in the paediatric population, and only 3-5% of all malignant ovarian neoplasms, [12], [4] yolk sac tumors being the second most common subtype, comprising about 1% of all ovarian malignancies. [5], [8] Yolk sac tumors also called Endodermal sinus tumor or recently recommendedprimitive endodermal tumor, are rare, highly aggressive and malignant that can be present in children and young adults [16] [10].…”

Section: Introductionmentioning

confidence: 99%

“…[3] Before the introduction of chemotherapy yolk sac tumors had a 5year survival rate of about 15%, nowadays this improved to about 90% with combination chemotherapy such as BEP (Bleomycin, Etoposide and Cisplatin). [4]…”

Section: Introductionmentioning

confidence: 99%

Recurrent Ovarian Yolk Sac Tumor in an 11-Year Old Girl – Case Report

Muntean¹,

Papa²,

Mironescu³

et al. 2019

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Ovarian cancer is responsible for 1-2% of all childhood malignancies, in children up to 85% of ovarian malignancies are histologically found to be germ cell tumors. Yolk sac tumors are the second most common subtype of germ cell tumors, they are aggressive rapidly growing and with frequent metastasis to other organs, and associated with elevated levels of alpha-fetoprotein. We present the case of an 11-year-old girl that was admitted to our hospital for abdominal pain, and a large abdominal tumor that occupied the whole hypogastric region of the abdomen. MRI showed a right ovarian tumor; tumor markers were obtained prior to surgery. Histological diagnosis of ovarian Yolk Sac Tumor was made and the patient was scheduled for chemotherapy. The patient and family interrupted all medical treatment and follow-up, presenting 5 months later, with recurrence on the contralateral ovary. Even if the ovarian yolk sac tumor has a good survival rate, the delay in starting chemotherapy and lack of compliance to treatment can give it a poor prognosis, and lead to recurrence or metastasis.

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“…Paediatric pelvic solid tumours present peculiar challenges in clinical diagnosis due to their inherently occult anatomic location, and the varied, often vague symptoms. [4,5] Difficult surgical access and presence of important surrounding pelvic structures are additional factors which make the surgical treatment of this heterogenous clinical group of childhood tumours particularly challenging. Even with the most careful dissections in the surgical treatment of the pre-sacral tumours, various degrees of injury to the pelvic splanchnic plexus and other neurological tissues are common.…”

Section: Introductionmentioning

confidence: 99%

Paediatric Pelvic Tumours; Presentation, Diagnosis and Challenges of Treatment in a Low Resource Setting

E¹,

Gracia²

2019

AJCPN

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Background: Paediatric pelvic solid tumours present peculiar challenge in clinical diagnosis due to their inherently obscure anatomic location, and the varied, often vague symptoms. Difficult surgical access and presence of important surrounding pelvic structures make their surgical treatment particularly challenging. Aim: To report our experience with paediatric pelvic solid tumours and to highlight the presentation pattern and challenges of diagnosis and treatment in our setting. Subjects and Methods: This is a five year retrospective study of pelvic solid tumours in children seen in our centre between December 2013 and November 2018. Data retrieved were demographics, presenting symptoms and duration, previous treatments, findings on examination, laboratory investigations, treatment given in our centre, histology of tumours and duration of follow up, outcome. Analysis was done on Microsoft Excel spread sheet Windows 2007. Results: Twenty three cases comprising 7 males and 16 females were included in this study. The age range was 1 to 14 years with a median at 6.5 years. Ten(43.5%) of these cases were benign, and 13(56.5%) were malignant. The teratomas comprised 9 benign cystic mature teratomas and 6 malignant teratomas. There were 4 mortalities and one recurrence. Conclusion: The anatomic location and vague early symptoms of pelvic tumours make early diagnosis difficult in our setting. High morbidity and mortality is the direct consequence. In a resource poor setting as ours, scrupulous physical examination including digital rectal examination is key to early diagnosis.

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Yolk Sac Tumor in an Eight-Year-Old Girl: A Case Report and Literature Review

Cited by 25 publications

References 45 publications

CT-Based Radiomics to Differentiate Pelvic Rhabdomyosarcoma From Yolk Sac Tumors in Children

CT-Based Radiomics to Differentiate Pelvic Rhabdomyosarcoma From Yolk Sac Tumors in Children

Recurrent Ovarian Yolk Sac Tumor in an 11-Year Old Girl – Case Report

Paediatric Pelvic Tumours; Presentation, Diagnosis and Challenges of Treatment in a Low Resource Setting

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