Pineal yolk sac tumor in a 65-year-old man

doi:10.1016/0090-3019(94)90273-9

Surgical Neurology

Volume 42, Issue 3, September 1994, Pages 253-258

https://doi.org/10.1016/0090-3019(94)90273-9 Get rights and content

Abstract

A 65-year-old man presented with a case of pure yolk sac tumor in the pineal region. The patient was admitted with a gait disturbance and elevated α-fetoprotein levels in serum and cerebrospinal fluid. He underwent total resection of the tumor. Cisplatin-vinblastine-bleomycin therapy was interrupted because of severe syndrome of inappropriate secretion of antidiuretic hormone, and there was recurrence of the tumor. Five months after the operation, he died in spite of carboplatin-etoposide therapy. A review of the literature revealed no previous report of pineal yolk sac tumor in an elderly patient. Problems in the diagnosis and treatment of such cases are discussed.

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Cited by (13)

Adult-Onset Mixed Germ Cell Tumor Composed Mainly of Yolk Sac Tumor Around the Pineal Gland: A Case Report and Review of the Literature
2019, World Neurosurgery
Citation Excerpt :
Previous studies have reported that GCTs are more frequent in Asian countries than in Western countries.3 However, to the best of our knowledge, only 4 detailed descriptions of intracranial YST in those aged >35 years exist.4-7 In these 4 patients, the tumors were located at the basal ganglia, pineal area, thalamus, and anterior third ventricle.
Mixed germ cell tumors (MGCTs) usually occur in children. In the present report, we discuss an extremely rare case of adult-onset MGCT composed mainly of yolk sac tumor (YST) around the pineal gland.
A 54-year-old Japanese man presented with disturbance of consciousness, Parinaud's syndrome, and gait disturbance. Magnetic resonance imaging revealed a pineal mass lesion, and subtotal resection of the tumor was achieved. The histologic diagnosis was MGCT, consisting mainly of YST. Although he underwent 5 courses of chemotherapy and craniospinal irradiation after surgery, tumor dissemination could not be controlled, and he died 10 months postoperatively.
The present case highlights the need for clinicians to include YST in the differential diagnosis of acute progressive lesions around the pineal region, even in adult patients.
Proton MR spectroscopy and diffusion-weighted imaging of intracranial germ cell tumors: Implications for differentiation from other lesions
2011, European Journal of Radiology Extra
Citation Excerpt :
These findings suggest that germinomas and teratomas could be differentiated based on DWI, but teratomas could not be further distinguished. Yolk sac tumors are usually heterogeneous, with foci of calcification and cysts and contrast enhancement [12,16]. In our case of yolk sac tumor, radiological differential diagnosis included: primary CNS lymphoma and other GCTs.
Intracranial germ cell tumors (GCT) are extremely rare brain neoplasms, with imaging characteristics being often non-specific. Considering such imaging limitation in establishing their exact histology, the aim of this paper is to integrate conventional, physiologic and metabolic magnetic resonance imaging (MRI) with histology of these tumors, with the goal of proposing some new insights that could aid in their diagnosis.
We have retrospectively analyzed preoperative imaging findings in 9 patients with histology proven intracranial germ cell tumors. In all patients conventional magnetic resonance imaging in conjunction with diffusion-weighted imaging (DWI) and proton magnetic resonance spectroscopy (MRS) was performed.
Based on imaging characteristics on conventional sequences germinoma cannot be differentiated from nongerminoma. DWI offered the potential for differentiation of germinomas from non-germinomas since solid part of germinomas demonstrated restricted diffusion with ADC values under 1.0 × 10⁻³ mm²/s, whereas nongerminoma showed elevated diffusion with ADC values above 1.3 × 10⁻³ mm²/s. Short echo MRS demonstrated characteristic spectra in germinomas: increased Cho, decreased NAA and prominent broad lipid resonances.
DWI and MRS imaging findings provide additional information that can facilitate evaluation of intracranial germ cell tumors.
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
2023, Internal Medicine
Pineal Region Tumors in Pediatric Patients
2022, Pediatric Neurosurgery for Clinicians
Intracranial yolk sac tumor in an adult patient: MRI, diffusionweighted imaging and <sup>1</sup>H MR spectroscopy features
2012, Vojnosanitetski Pregled
Primary yolk sac tumor within the lateral ventricle - Case report
2009, Neurologia Medico-Chirurgica

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NeoplasmPineal yolk sac tumor in a 65-year-old man

Abstract

J Pediatr Surg

Surg Neurol

Treatment and prognosis of primary intracranial germ cell tumors

Neurol Med Chir (Tokyo)

Primary intracranial germ cell tumors including five cases of endodermal sinus tumor

Acta Pathol Microbiol Scand (A)

Non adjuvant chemotherapy for newly diagnosed germ-cell tumors of the central nervous system

J Neurosurg

Intracranial endodermal sinus tumor-role for chemotherapy

Can J Neurol Sci

Primary pineal endodermal sinus tumor with elevated serum and CSF alpha-fetoprotein levels

Intracranial and intraspinal dissemination from pineal yolk sac tumor treated by PVB therapy

Neurol Med Chir (Tokyo)

Endodermal sinus tumor of the pineal region: metastases through a ventriculo-peritoneal shunt

Cancer

Spinal cord compression associated with a tumor in the pineal region

N Engl J Med

Extragonadal endodermal sinus tumors originating in the region of the pineal gland

Acta Pathol Microbiol Scand

Intracranial germ-cell tumors: pathobiological and immunohistochemical aspects of 70 cases

J Neuropathol Exp Neurol

Surgical pathology of the nervous system and its coverings

Pineal region tumors in children

J Neurosurg

Primary intracranial germ cell tumors

Acta Neuropathol

Intracranial germ cell tumors: natural history and pathogenesis

J Neurosurg

Neoplasm
Pineal yolk sac tumor in a 65-year-old man