Pineal yolk sac tumor
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Synonyms and keywords: Pineal yolk sac tumors; Pineal yolk sac tumour; Pineal yolk sac tumours; Pineal endodermal sinus tumor; Pineal endodermal sinus tumors; Pineal endodermal sinus tumour; Pineal endodermal sinus tumours; Pineal yolk sac carcinoma; Pineal yolk sac carcinomas; Pineal gland tumor; Germ cell tumor; Brain tumor
Overview
- Pineal yolk sac tumor is a rare type of extra gonadal yolk sac tumor. They make up a small fraction of all intracranial germ cell tumors and an even small fraction of pineal masses overall.[1]
- Pure pineal yolk sac tumors secrete AFP.
- On microscopic histopathological analysis, pineal yolk sac tumor is characterized by poorly differentiated endothelium-like, cuboidal, or columnar cells with prominent nucleoli and significant mitotic activity.[2]
- Pineal yolk sac tumor is demonstrated by positivity to tumor markers such as AFP, cytokeratin, and AAT.[3] PAS-diastase positive hyaline globules and Schiller-Duval bodies are the characteristic features of pineal yolk sac tumors.[2]
- In upto 50% of cases, these tumors co-exist with other germ cell tumors.[4]
- Pineal yolk sac tumor may be associated with Down syndrome.[5]
- Common complication of pineal yolk sac tumor includes obstructive hydrocephalus.
- Prognosis of pineal yolk sac tumor is generally poor.[3]
- Symptoms of pineal yolk sac tumor include headache, nausea, vomiting, weakness, confusion, and somnolence.[2][3]
- Head CT scan and brain MRI may be helpful in the diagnosis of pineal yolk sac tumor.
- On head CT scan, pineal yolk sac tumor is characterized by a hypodense, heterogenous mass in the pineal region with signs of obstructive hydrocephalus.
- On brain MRI, pineal yolk sac tumor is characterized by hypointensity on T1-weighted images and hyperintensity on T2-weighted images. There may be enhancement after contrast administration.[2]
- Biopsy is generally done to confirm the diagnosis of pineal yolk sac tumor.[2]
- The mainstay of therapy for pineal yolk sac tumor is radiotherapy and/or chemotherapy. Sometimes, surgical resection may be done.[2]
References
- ↑ Pineal yolk sac tumour. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/pineal-yolk-sac-tumour. Accessed on December 8, 2015
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Davaus T, Gasparetto EL, Carvalho Neto Ad, Jung JE, Bleggi-Torres LF (2007). "Pineal yolk sac tumor: correlation between neuroimaging and pathological findings". Arq Neuropsiquiatr. 65 (2A): 283–5. PMID 17607429.
- ↑ 3.0 3.1 3.2 Tan HW, Ty A, Goh SG, Wong MC, Hong A, Chuah KL (2004). "Pineal yolk sac tumour with a solid pattern: a case report in a Chinese adult man with Down's syndrome". J Clin Pathol. 57 (8): 882–4. doi:10.1136/jcp.2004.016659. PMC 1770394. PMID 15280413.
- ↑ Pathology of pineal yolk sac tumour. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/pineal-yolk-sac-tumour. Accessed on December 9, 2015
- ↑ Associations of pineal yolk sac tumor. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/pineal-yolk-sac-tumour. Accessed on December 8, 2015