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

World Neurosurg. 2019 Dec:132:87-92. doi: 10.1016/j.wneu.2019.08.079. Epub 2019 Aug 27.

Abstract

Background: 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.

Case description: 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.

Conclusion: 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.

Keywords: Adult onset; Mixed germ cell tumor; Pineal region; Yolk sac tumor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • 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 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*
  • Positron-Emission Tomography
  • Tomography, X-Ray Computed