Primary mediastinal yolk sac tumor

Case contributed by Abdallah Al Khateeb

Presentation

Previously healthy. Chest discomfort and intractable dry cough.

Patient Data

Age: 25 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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