-
The American Journal of Case Reports Jan 2022BACKGROUND Mediastinal masses can originate from anatomical structures normally located in the mediastinum, or from structures that travel through the mediastinum during...
BACKGROUND Mediastinal masses can originate from anatomical structures normally located in the mediastinum, or from structures that travel through the mediastinum during embryogenesis. Initial presenting symptoms usually vary from shortness of breath, cough, chest pain, and superior vena cava syndrome to nonspecific constitutional symptoms (eg, fever, weight loss, fatigue). However, the initial presentation of a mediastinal mass with acute pericarditis has not been reported in the literature as far as we know. CASE REPORT A 20-year-old man presented to the Cardiology Clinic with chest pain and new pericardial effusion on echocardiography, both fulfilling the diagnostic criteria of acute pericarditis. The patient also had venous engorgement on the neck, and a chest X-ray followed by computed tomography imaging showed a large mediastinal mass. The serum tumor marker a-fetoprotein (AFP) was markedly elevated. The biopsy and immunohistochemistry revealed a high-grade malignant neoplasm - yolk sac tumor, which is a type of non-seminomatous germ cell tumor. The acute pericarditis resolved after administration of NSAID and colchicine. The patient was then started on chemotherapy. CONCLUSIONS The discussed case shows the rare presentation of an anterior mediastinal mass with acute pericarditis. This emphasizes the importance of a thorough review of systems and critical analysis of every sign and symptom at the time of initial presentation, which helps the physician to obtain appropriate imaging studies early in the course, leading to an early diagnosis and treatment of the disease, such as in this case of an extremely rare germ cell tumor.
Topics: Adult; Endodermal Sinus Tumor; Humans; Male; Mediastinal Neoplasms; Mediastinum; Pericarditis; Superior Vena Cava Syndrome; Young Adult
PubMed: 35077441
DOI: 10.12659/AJCR.932616 -
Cancer Cytopathology Apr 2023In this study, the authors sought to describe the cytologic features of primary gynecologic germ cell tumors and carcinomas exhibiting germ cell differentiation because...
BACKGROUND
In this study, the authors sought to describe the cytologic features of primary gynecologic germ cell tumors and carcinomas exhibiting germ cell differentiation because little information currently exists.
METHODS
An institutional database search was performed to identify histologically confirmed gynecologic germ cell tumors and carcinomas with germ cell tumor differentiation. Available cytologic material was reviewed by three observers, and morphologic features were recorded in addition to patient age at original diagnosis, primary tumor site, site(s) from which the examined cytologic material was obtained, and the type of examined cytologic preparations.
RESULTS
In total, 15 cytologic specimens from 12 women (aged 19-82 years) were identified and included touch preparations of core biopsies from various sites (n = 6), fine-needle biopsies (n = 2), pelvic washings (n = 1), ascitic fluids (n = 4), pelvic cyst fluid (n = 1), and endometrial aspirate (n = 1). Of the 12 patients, seven had primary gynecologic germ cell tumors, four had gynecologic (ovarian and endometrial) tumors exhibiting somatic yolk sac tumor-like differentiation, and the remaining patient had an intestinal-type adenocarcinoma arising within an ovarian teratoma. There was morphologic overlap among many of the cases, although cytoplasmic vacuolation/granular cytoplasm was seen in 75% of primary yolk sac tumors or carcinomas with yolk sac tumor differentiation, and dense/squamoid cytoplasm was seen in 100% of teratomatous elements that were sampled.
CONCLUSIONS
Germ cell tumors and somatic neoplasms exhibiting germ cell tumor differentiation occurring in adult women share some cytologic features and may be difficult to distinguish from one another, although some tumor types showed characteristic cytomorphologic findings.
Topics: Adult; Humans; Female; Endodermal Sinus Tumor; Neoplasms, Germ Cell and Embryonal; Teratoma; Ovarian Neoplasms; Adenocarcinoma
PubMed: 36574209
DOI: 10.1002/cncy.22673 -
The American Journal of Case Reports Oct 2021BACKGROUND Existing literature has detailed occurrences of retroperitoneal yolk sac tumors (YSTs) as the result of metastasis from a primary gonadal site. However,...
BACKGROUND Existing literature has detailed occurrences of retroperitoneal yolk sac tumors (YSTs) as the result of metastasis from a primary gonadal site. However, primary retroperitoneal YSTs are extremely rare, thus remaining a challenge to diagnose and treat. We present a complex case of a large primary retroperitoneal YST in a man treated with neoadjuvant chemotherapy followed by surgical resection. CASE REPORT A 31-year-old man presented with a chief symptom of severe lower abdominal pain. Diagnostic imaging revealed a large, rapidly progressing neoplasm in the retroperitoneal region, initially thought to be a sarcoma. However, the pathological results from further biopsies found the mass to be a retroperitoneal YST, which was tethered to a large portion of the small bowel. A testicular ultrasound was used to confirm that the mass was a primary tumor with no origins in the gonads. The tumor progressed to involve several fistulas connected to the small intestine and anterior abdominal wall. The patient was treated with 3 cycles of bleomycin, etoposide, and cisplatin, followed by surgical excision of the residual mass. The patient retained normal gastrointestinal functions, and subsequent imaging revealed no evidence of recurrence 2.5 years following resection. CONCLUSIONS Owing to the rarity of extragonadal primary YSTs, diagnostic and treatment standards have not yet been sufficiently explored. Our case demonstrates that a combination of chemotherapy and surgical resection should be considered for select patients with primary YST in the retroperitoneal region.
Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Endodermal Sinus Tumor; Etoposide; Humans; Male; Neoplasm Recurrence, Local; Retroperitoneal Neoplasms
PubMed: 34705815
DOI: 10.12659/AJCR.933258 -
Anticancer Research Sep 2021Testicular cancer constitutes 1.0% of male cancer and typically carries a good prognosis. As far as we are aware, the role for hydrogen sulfide in testicular cancer and...
BACKGROUND
Testicular cancer constitutes 1.0% of male cancer and typically carries a good prognosis. As far as we are aware, the role for hydrogen sulfide in testicular cancer and the level of hydrogen sulfide-synthesizing enzyme have never been addressed. Here we examined cystathionine gamma-lyase (CSE) expression in several germ-cell testicular tumors.
MATERIALS AND METHODS
Tissue microarrays were employed to examine CSE expression in 32 benign testicular samples, 88 testicular seminomas, 34 embryonal carcinomas, 4 mature teratomas, and 16 yolk sac tumors, and CSE expression was compared to that seen in benign testicular tissue.
RESULTS
Compared to benign testicular tissue, CSE expression was increased in all three types of testicular neoplasm but not in mature teratomas. Highest CSE expression was identified in embryonal carcinomas, which often show a relatively aggressive clinical course.
CONCLUSION
For the first time, we show that CSE is increased in several common testicular germ-cell tumor types.
Topics: Carcinoma, Embryonal; Case-Control Studies; Cystathionine gamma-Lyase; Endodermal Sinus Tumor; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Humans; Male; Seminoma; Testicular Neoplasms; Tissue Array Analysis; Up-Regulation
PubMed: 34475040
DOI: 10.21873/anticanres.15225 -
The American Journal of Pathology Nov 1993Heymann nephritis in the rat is the most widely used model of human membranous glomerulonephritis. Glycoprotein (gp)330, a large (M(r) > 550,000) membrane-associated...
Heymann nephritis in the rat is the most widely used model of human membranous glomerulonephritis. Glycoprotein (gp)330, a large (M(r) > 550,000) membrane-associated glycoprotein, has been identified as the main antigen in this autoimmune disease. Studies of gp330 and receptor-associated protein (RAP), its 44-kd subunit, have been restricted largely to rat kidney, as no stable cultured cell line has been available that expresses gp330. We have recently identified a rat yolk sac carcinoma cell line (L2) that expresses both gp330 and RAP. In this report, we have carried out detailed morphological, immunocytochemical, and biochemical studies characterizing the biosynthesis and localization of gp330 and RAP in the L2 rat yolk sac cell line. At the electron microscope level, the L2 cells are seen to be attached by cell junctions, and their predominant morphological features include extensive networks of rough endoplasmic reticulum (ER) and numerous clathrin-coated pits found on the cell membrane. By immunocytochemistry, gp330 was localized primarily to clathrin-coated pits at the cell surface, whereas RAP was localized predominantly to the lumen of the rough ER. Pulse-chase experiments indicated that gp330 spends a prolonged time maturing in the ER of L2 cells, as transport of gp330 to the Golgi complex (based on acquisition of endoglycosidase H resistance) is slow (t1/2 = 90 to 120 minutes). Gp330 reached the L2 cell surface beginning at 2 hours after synthesis, where it could be detected by cell surface immunoprecipitation. RAP was found to be an N-linked glycoprotein, and it remained endoglycosidase H-sensitive up to 4 hours after synthesis. Co-precipitation and co-sedimentation experiments demonstrated that gp330 and RAP form a large heterodimer (M(r) approximately 669,000) immediately after biosynthesis and are further assembled into a large hetero-oligomer in the ER. These findings demonstrate that the localization and the kinetics of assembly of gp330 and RAP into the Heymann nephritis antigenic complex are similar in both L2 cells and rat kidney. They also provide new information on the intracellular processing of these two molecules and their delivery to the cell surface. Thus, the L2 cell system should facilitate further characterization of the functions and interactions of gp330 and RAP, which may shed light on the cellular and molecular mechanisms of Heymann nephritis.
Topics: Animals; Biological Transport; Endodermal Sinus Tumor; Endoplasmic Reticulum; Female; Heymann Nephritis Antigenic Complex; Membrane Glycoproteins; Microscopy, Electron; Ovarian Neoplasms; Peptide Fragments; Rats; Tumor Cells, Cultured
PubMed: 8238258
DOI: No ID Found -
Ai Zheng = Aizheng = Chinese Journal of... Apr 2009The imaging of presacral tumors in children is characteristic. Computed tomography (CT) and magnetic resonance imaging (MRI) have great values in identifying the...
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.
Topics: Adolescent; Child; Child, Preschool; Endodermal Sinus Tumor; Female; Humans; Infant; Magnetic Resonance Imaging; Male; Neuroblastoma; Retroperitoneal Neoplasms; Rhabdomyosarcoma; Sacrococcygeal Region; Teratoma; Tomography, Spiral Computed
PubMed: 19622305
DOI: No ID Found -
Modern Pathology : An Official Journal... Oct 2016Yolk sac tumors occur at both gonadal and extra-gonadal sites. A recent case of ovarian endometrioid-pattern yolk sac tumor with strong diffuse expression of TTF-1...
Yolk sac tumors occur at both gonadal and extra-gonadal sites. A recent case of ovarian endometrioid-pattern yolk sac tumor with strong diffuse expression of TTF-1 illustrated the potential for misdiagnosis due to divergent expression of endodermal lineage markers. The aim of this study was to investigate the expression of four divergent endodermal lineage markers, TTF-1, CDX2, Hep Par 1, and Napsin A, in gonadal and extra-gonadal yolk sac tumors of differing age, sex, and location (excluding foci of overt hepatoid differentiation). We identified 26 cases (5 ovarian, 15 testicular, and 6 extra-gonadal) containing yolk sac tumor as identified by typical histology and confirmed by positive immunohistochemical staining for alpha-fetoprotein and glypican-3. Mixed or ambiguous foci were confirmed by immunohistochemistry (SALL4 positive and Oct-4 negative). The relative proportion of three histologic patterns: reticular/cystic, solid/myxoid, and glandular was estimated. Percent positivity for the four divergent endodermal lineage markers was compared within yolk sac tumor areas according to site, age group, and histologic pattern. High-level (>25%) staining for one or more divergent endodermal lineage markers was seen in eleven cases: Hep Par 1 in seven cases, all post-pubertal, TTF-1 in four cases, two ovarian and two extra-gonadal, and CDX2 in three cases, with no age or site predilection. No case highly expressed all three divergent endodermal lineage markers, but four co-expressed high levels of two markers: two ovarian yolk sac tumors with TTF-1 and Hep Par 1, one testicular yolk sac tumor with CDX2 and Hep Par 1, and one extra-gonadal yolk sac tumors with TTF-1 and CDX2. While no absolute correlation of high-level divergent endodermal lineage marker expression with histologic subtype was observed, TTF-1 and CDX2 expression was predominantly seen in reticular/cystic and glandular areas while Hep Par 1 was most frequent in myxoid/solid and glandular areas.
Topics: Adolescent; Adult; Biomarkers, Tumor; Cell Lineage; Child; Child, Preschool; Endodermal Sinus Tumor; Female; Humans; Infant; Male; Neoplasms, Germ Cell and Embryonal; Nose Neoplasms; Ovarian Neoplasms; Sacrococcygeal Region; Soft Tissue Neoplasms; Testicular Neoplasms; Young Adult
PubMed: 27443515
DOI: 10.1038/modpathol.2016.131 -
Andrology Jan 2015Four cases are reported meeting the criteria of a pediatric (i.e., Type I) testicular germ cell tumor (TGCT), apart from the age of presentation, which is beyond...
Four cases are reported meeting the criteria of a pediatric (i.e., Type I) testicular germ cell tumor (TGCT), apart from the age of presentation, which is beyond childhood. The tumors encompass the full spectrum of histologies of pediatric TGCT: teratoma, yolk sac tumor, and various combinations of the two, and lack intratubular germ cell neoplasia/carcinoma in situ in the adjacent parenchyma. The neoplasms are (near)diploid, and lack gain of 12p, typical for seminomas and non-seminomas of the testis of adolescents and adults (i.e., Type II). It is proposed that these neoplasms are therefore late appearing pediatric (Type I) TGCT. The present report broadens the concept of earlier reported benign teratomas of the post-pubertal testis to the full spectrum of pediatric TGCT. The possible wide age range of pediatric TGCT, demonstrated in this study, lends credence to the concept that TGCT should according to their pathogenesis be classified into the previously proposed types. This classification is clinically relevant, because Type I mature teratomas are benign tumors, which are candidates for testis conserving surgery, as opposed to Type II mature teratomas, which have to be treated as Type II (malignant) non-seminomas.
Topics: Adolescent; Age of Onset; Biomarkers, Tumor; Biopsy; Endodermal Sinus Tumor; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Male; Neoplasm Staging; Neoplasms, Complex and Mixed; Orchiectomy; Teratoma; Testicular Neoplasms; Time Factors; Treatment Outcome; Young Adult
PubMed: 25427839
DOI: 10.1111/andr.305 -
British Journal of Cancer Jan 2016The current biomarkers alpha-fetoprotein and human chorionic gonadotropin have limited sensitivity and specificity for diagnosing malignant germ-cell tumours (GCTs)....
BACKGROUND
The current biomarkers alpha-fetoprotein and human chorionic gonadotropin have limited sensitivity and specificity for diagnosing malignant germ-cell tumours (GCTs). MicroRNAs (miRNAs) from the miR-371-373 and miR-302/367 clusters are overexpressed in all malignant GCTs, and some of these miRNAs show elevated serum levels at diagnosis. Here, we developed a robust technical pipeline to quantify these miRNAs in the serum and cerebrospinal fluid (CSF). The pipeline was used in samples from a cohort of exclusively paediatric patients with gonadal and extragonadal malignant GCTs, compared with appropriate tumour and non-tumour control groups.
METHODS
We developed a method for miRNA quantification that enabled sample adequacy assessment and reliable data normalisation. We performed qRT-PCR profiling for miR-371-373 and miR-302/367 cluster miRNAs in a total of 45 serum and CSF samples, obtained from 25 paediatric patients.
RESULTS
The exogenous non-human spike-in cel-miR-39-3p and the endogenous housekeeper miR-30b-5p were optimal for obtaining robust serum and CSF qRT-PCR quantification. A four-serum miRNA panel (miR-371a-3p, miR-372-3p, miR-373-3p and miR-367-3p): (i) showed high sensitivity/specificity for diagnosing paediatric extracranial malignant GCT; (ii) allowed early detection of relapse of a testicular mixed malignant GCT; and (iii) distinguished intracranial malignant GCT from intracranial non-GCT tumours at diagnosis, using CSF and serum samples.
CONCLUSIONS
The pipeline we have developed is robust, scalable and transferable. It potentially promises to improve clinical management of paediatric (and adult) malignant GCTs.
Topics: Adolescent; Biomarkers, Tumor; Carcinoma, Embryonal; Central Nervous System Neoplasms; Child; Child, Preschool; Choriocarcinoma, Non-gestational; Chorionic Gonadotropin; Endodermal Sinus Tumor; Female; Germinoma; Humans; Infant; Infant, Newborn; Male; MicroRNAs; Neoplasm Recurrence, Local; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Polymerase Chain Reaction; Sacrococcygeal Region; Sensitivity and Specificity; Testicular Neoplasms; alpha-Fetoproteins
PubMed: 26671749
DOI: 10.1038/bjc.2015.429 -
International Journal of Clinical and... 2015We report one case of yolk sac tumor of the ear and review the literature. The patient was a 9-month boy who scratched his right ear repeatedly one month ago. Computed... (Review)
Review
We report one case of yolk sac tumor of the ear and review the literature. The patient was a 9-month boy who scratched his right ear repeatedly one month ago. Computed tomography scan showed an irregular elongated mass image measuring 42×16 mm was found in the right external auditory canal. The tumor was located underneath of the epidermis with ulceration. Mild or moderate atypical round or oval tumor cells were arranged in nest and reticular pattern around vesicular or cystic spaces. Tumor cells had abundant eosinophilic or clear cytoplasm and marked nucleoli. Mitotic figures were about 7/10 HPF. Poorly formed Schiller-Duvall body was occasionally present. The stroma was loose and rich in capillaries. Hyaline globules could be found in the stroma. Immunohistochemistry staining showed that tumor cells were positive for cytokeratin, SALL4, glypican-3, focal positive for EMA, vimentin, CD10, and CD34, but negative for a-fetoprotein, HCG, PLAP. The serum α-fetoprotein was 664.60 ng/mL (normal, ≤ 25 ng/mL). Yolk sac tumor of the ear is extremely rare, especially α-fetoprotein negative expression in our case. The differential diagnosis includes embryonal rhabdomyosarcoma, paraganglioma, myoepithelioma, carcinoma of skin appendages, and metastatic renal cell carcinoma.
Topics: Biomarkers, Tumor; Ear Canal; Ear Neoplasms; Endodermal Sinus Tumor; Humans; Immunohistochemistry; Infant; Male
PubMed: 26823835
DOI: No ID Found