Testicular yolk sac tumor

Case contributed by Ammar Ashraf


Left scrotal swelling for the past two months.

Patient Data

Age: 16 months
Gender: Male

The left testis is grossly enlarged and replaced with a heterogeneous mass containing multiple cystic areas within it. Minimal vascularity is seen in it on color Doppler ultrasound examination. No calcifications are seen in it. Right testis is normal.


Enlarged left testis replaced by a complex, predominantly cystic, mass lesion measuring 4.5 x 3 cm. The lesion shows heterogeneous enhancement on the post-contrast study. No calcifications, fat, hemorrhage or diffusion restriction is seen. No capsular disruption or locoregional lymphadenopathy is noted. The right testis is unremarkable. Both inguinal canals are unremarkable.


Histopathology of the left orchiectomy specimen revealed yolk sac tumor.

Case Discussion

  • laboratory investigations showed a markedly elevated AFP level of 11351.9 ng/ml (cf. a reference level of 0.8-87 ng/ml for the patient's age 1)

  • age of the patient, imaging features and laboratory investigations were suggestive of yolk sac tumor, which was later confirmed by histopathology

  • the baby was referred to the pediatric oncologist for further management, where a baseline staging CT chest, abdomen and pelvis was performed, which was negative for any distant metastasis

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