Primary mediastinal yolk sac tumour

Case contributed by Dr Abdallah Khateeb

Presentation

Previously healthy. Chest discomfort and intractable dry cough.

Patient Data

Age: 27 years old
Gender: Male
  • Large lobulated opacity involving the right middle and lower lung zones with mass effect on the right main bronchus.
  • Hilar overlay sign and observation of branching pulmonary arteries are clearly observed, pointing to an anterior mediastinal mass.
  • Lobulated right-sided heterogeneous anterior mediastinal mass with central necrosis.
  • Mild mass effect on the surrounding structures (trachea, right main bronchus and pulmonary arteries).
  • The tumor has a broad pleural base with acute angles to the chest wall, indicating an intrapleural or intraparenchymal origin.
Ultrasound
  • Bilateral testicular microlithiasis.
  • The association between testicular microlithiasis and germ cell tumors is controversial.

Elevated alpha fetoprotein, normal beta-hCG.

Case Discussion

Excisional biopsy was performed.

Tumor cells are positive for SALL4, Glypican3 and GATA3. They are negative for CD30 and hCG.

Final diagnosis: yolk sac tumor.

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Case information

rID: 48445
Case created: 7th Oct 2016
Last edited: 29th Aug 2017
Inclusion in quiz mode: Included

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