Search

Yolk sac tumor (YST) is a rare malignancy typically occurring in children. However, bilateral testicular YSTs are a quite rare situation, which can occur metachronously or synchronously with same histologic type, as well as different histology. We present a case of synchronous YST of the left testis and mature teratoma of the right in a 7-month-old infant treated with testis-sparing surgery at right testis and high radical orchiectomy at left. By follow-up of 28th month, no atrophy, or residual tumor in right testis and no recurrence or evidence of disease in left scrotum was found., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: The accurate histologic diagnosis of germ cell tumors in the pineal region is a keystone for determining the best treatment strategy and prognosis. This situation poses a challenge for the neuropathologist, considering the lack of a standarized procedure to obtain biopsy samples, which results in few and small specimens, which are not suitable for diagnosis., Case Description: We report a case in which a pineal region mixed germ cell tumor was accurately diagnosed by performing histologic mapping through a dual burr-hole endoscopic approach. The technical pitfalls and other considerations necessary for obtaining an accurate diagnosis in this tumor subgroup are specified. In addition, the histologic analysis regarding the sampling technique used is described., Conclusions: The supraorbital frontal endoscopic approach enables the surgeon to perform histologic mapping of pineal region tumors, allowing standarization of the procedure used to obtain the specimens. This approach could result in a more accurate diagnosis, especially in mixed germ cell neoplasms., (Copyright © 2016 Elsevier Inc. All rights reserved.)

An intrapericardial vacuolated mass compressing and displacing the heart was diagnosed by echocardiography in a foetus of 22 weeks gestation. The birth was induced for early signs of foetal distress at 29 weeks and, after two initial pericardial evacuation procedures, the tumour was resected radically 7 days after birth at a weight of 1.55 kg. Mass histology showed teratoma associated with yolk sac tumour. We comment on the overall approach adopted after foetal diagnosis and the histopathological features of the tumour, and try to draw conclusions on patient outcome data.

Malignant germ cell tumors of the ovary are very rare and account for about 2-5% of all ovarian tumors of germ origin. Most patients are adolescent and young women, approximately two-thirds of them are under 20 years of age, occasionally in postmenopausal women. But clear cell carcinoma usually occurs in older patients (median age: 57-year old), and closely related with endometriosis. Here we report a case of a 55-year old woman with right ovarian mass that discovered by B ultrasonic. Her serum levels of human chorionic gonadotropin (hCG) and α-fetoprotein (AFP) were elevated. Pathological examination revealed the tumor to be a mixed germ cell tumor (yolk sac tumor, embryonal carcinoma and mature teratoma) with clear cell carcinoma in a background of endometriosis. Immunohistochemical staining showed SALL4 and PLAP were positive in germ cell tumor area, hCG, CD30 and OCT4 were positive in epithelial-like cells and giant synctiotrophoblastic cells, AFP, AAT, CD117 and Glyp3 were positive in yolk sac component, EMA and CK7 were positive in clear cell carcinoma, CD10 was positive in endometrial cells of endometriotic area. She was treated with surgery followed by seven courses of chemotherapy. She is well and serum levels of hCG and AFP have been decreased to normal levels.

Objective: Germ cell tumours are the most common ovarian neoplasms in childhood and, of these, teratomas, whether mature or immature, are the most frequently found. Mature teratoma is a benign tumour, whereas the immature type, although also benign, has a more aggressive course, with a propensity to recurrence. A review of the literature revealed that there are some imaging features that may help to differentiate between these 2 types of teratoma, although no systematic comparison has been made. The objective of this study was to review imaging features of ovarian teratomas in children and to assess differentiating imaging features between the mature and immature types of ovarian teratoma., Methods: Retrospective analysis of all patients who presented to our institution during a 9-year period (September 1999 to August 2008) with ovarian teratoma as confirmed on histology., Results: Forty-one patients with pathologically proven ovarian teratoma were found. The patient ages ranged from 4-18 years at presentation (mean [standard deviation] age, 12.4 +/- 3.4 years; median age, 13 years). Thirty patients (73.2%) were found to have mature ovarian teratoma, and 11 (26.8%) had immature teratoma. A component of endodermal sinus tumour was found in one of the immature teratomas. On ultrasonography, the appearance of the immature teratomas was purely solid in 3 (27.3%), mixed solid and cystic in 6 (54.5%), and predominantly cystic in 2 (18%). The mature ovarian teratomas demonstrated a predominantly cystic appearance in 22 (73.3%) and a mixed solid and cystic appearance in 8 (26.6%); there were no cases with a pure solid appearance. The prevalence of the more cystic appearance of the mature type showed significant statistical difference when compared with its prevalence in the immature type (P = .0008, chi(2) test). Other imaging features, such as size, presence of fat, or calcifications, did not show a significant difference between the 2 types of teratoma., Conclusions: The predominance of a cystic component and a pure solid component in ovarian teratoma are significant differentiating factors between the mature type and the more aggressive immature type of teratoma., (2010 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.)

Background and Objective: The imaging of presacral tumors in children is characteristic. Computed tomography (CT) and magnetic resonance imaging (MRI) have great values in identifying the position, contents and invasion of pediatric presacral tumors before operation. This study was to investigate the CT and MRI features of pediatric presacral tumors, and evaluate the diagnostic values of CT and MRI., Methods: The CT and MRI data of 24 pediatric presacral tumors were analyzed together with pathologic results., Results: Six cases of pediatric presacral tumors were cystic type, with clear margin and complete capsule, and were composed of multi-capsular spaces; on enhanced scan, the capsular wall showed enhancement, while the cystic contents didn't; all these six cases were confirmed benign by pathology. Five cases were solid type and were enhanced inhomogeneously; all were confirmed malignant by pathology. Thirteen cases were cystic-solid type or with obvious necrosis in solid mass. Of the 13 cases, seven were cystic-solid teratoma (including four benign teratomas and three malignant teratomas confirmed by pathology), containing strip calcification, soft tissue and fat; five were endodermal sinus tumors, showing alveolate enhancement; one was neuroblastoma, with macro-lamellar necrosis, extension to the canalis vertebralis and sacrum invasion. Five tumors, including three teratomas, one rhabdomyosarcoma and one endodermal sinus tumor, had unclear margin. Sacrum invasion was found in one teratoma, one rhabdomyosarcoma, one neuroblastoma and one lymphangioma., Conclusions: The location and extend of pediatric presacral tumors can by clearly pictured on CT and MRI. Most tumors can be correctly diagnosed according to their imaging features.

Germ cell tumors of the sacrococcygeal region include mature and immature teratomas and endodermal sinus tumor. Most sacrococcygeal teratomas are discovered in the newborn period as an obvious mass, but they may be detected prenatally. Endodermal sinus tumors are usually discovered later in early childhood. Pathologically and radiologically, teratomas are either both cystic and solid, predominantly cystic, or rarely solid. Over 50% have calcification or ossification. Most malignant teratomas have substantial solid components and may contain calcification. Treatment is surgical excision including coccygectomy. Malignant tumors are treated with both surgery and chemotherapy. Prognosis is excellent for teratoma, although local recurrences may occur. Malignant teratomas have had a dismal prognosis in the past, which has been improved with multiagent chemotherapy.

The computed tomographic (CT) and magnetic resonance imaging (MRI) features of 73 histologically proven primary intracranial germ cell tumors were analysed. CT images were available for all 73 patients, and 22 of them were also examined by MRI. The tumors were classified as germinoma, mature teratoma, immature or malignant teratoma, yolk sac tumor, choriocarcinoma, embryonal carcinoma and mixed type. Germinoma was revealed as a high- or slightly high-density area on plain CT scan, and was enhanced homogeneously. MRI revealed iso- or slightly low signal intensity on T1-weighted images, and iso- or high intensity on T2-weighted images. Mature teratoma, which had a clear margin on neuroradiological images, was characterized by mixed density on CT scans, often showing large cysts and area of calcification. Immature or malignant teratoma had a similar pattern to that of mature teratoma, but the cystic components and area of calcification tended to be less and smaller respectively. The tumor margin was obscure in malignant teratoma, and perifocal edema was observed in some cases. The shape of yolk sac tumors was irregular. Plain CT scan revealed an iso- or low-density mass with good heterogeneous enhancement. Perifocal edema was observed in some cases. In mixed germ cell tumors, MRI imaging was useful for detecting teratomatous components, particularly fatty components. Although definite histological diagnosis cannot be achieved by CT and/or MRI alone, detailed analysis of neuroradiological images are useful for predicting the histological diagnosis.