Adult-Onset Mixed Germ Cell Tumor Composed Mainly of Yolk Sac Tumor Around the Pineal Gland: A Case Report and Review of the Literature

• Published in: World neurosurgery Vol. 132; pp. 87 - 92
• Main Authors: Uda, Hiroshi, Uda, Takehiro, Nakajo, Kosuke, Tanoue, Yuta, Okuno, Takahiro, Koh, Saya, Onishi, Yohei, Ohata, Hiroki, Watanabe, Yusuke, Umaba, Ryoko, Kawashima, Toshiyuki, Ohata, Kenji
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2019
• Subjects: Adult onset; Brain Neoplasms - complications; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - pathology; Brain Neoplasms - therapy; Consciousness Disorders - etiology; Endodermal Sinus Tumor - complications; Endodermal Sinus Tumor - diagnostic imaging; Endodermal Sinus Tumor - pathology; Endodermal Sinus Tumor - therapy; Fatal Outcome; Gait Disorders, Neurologic - etiology; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Mixed germ cell tumor; Mixed Tumor, Malignant - complications; Mixed Tumor, Malignant - diagnostic imaging; Mixed Tumor, Malignant - pathology; Mixed Tumor, Malignant - therapy; Neoplasms, Germ Cell and Embryonal - complications; Neoplasms, Germ Cell and Embryonal - diagnostic imaging; Neoplasms, Germ Cell and Embryonal - pathology; Neoplasms, Germ Cell and Embryonal - therapy; Ocular Motility Disorders - etiology; Pineal Gland; Pineal region; Positron-Emission Tomography; Tomography, X-Ray Computed; Yolk sac tumor; Pineal region; MGMT; Yolk sac tumor; Adult onset; Mixed germ cell tumor; CSI; GCT; YST; sAFP; MGCT
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2019.08.079

Mixed germ cell tumors (MGCTs) usually occur in children. In the present report, we discuss an extremely rare case of adult-onset MGCT composed mainly of yolk sac tumor (YST) around the pineal gland.
A 54-year-old Japanese man presented with disturbance of consciousness, Parinaud's syndrome, and gait disturbance. Magnetic resonance imaging revealed a pineal mass lesion, and subtotal resection of the tumor was achieved. The histologic diagnosis was MGCT, consisting mainly of YST. Although he underwent 5 courses of chemotherapy and craniospinal irradiation after surgery, tumor dissemination could not be controlled, and he died 10 months postoperatively.
The present case highlights the need for clinicians to include YST in the differential diagnosis of acute progressive lesions around the pineal region, even in adult patients.