Testicular yolk sac tumor
Testicular yolk sac tumors (also known as endodermal sinus tumor of the testis) is the most common childhood testicular tumor (80%), with most cases occurring before the age of two years . In adults, pure yolk sac tumor is extremely rare, however mixed germ cell tumor is commonly seen.
Pathology
Etiology
Totipotent cells, which later form extraembryonic fetal membranes, give rise to yolk sac tumors.
Features
Perivascular structures called Schiller-Duval bodies can be found in 50% of tumors and are pathognomonic.
Markers
AFP (alpha fetoprotein) is elevated in >90% cases of yolk sac tumor. Macroscopically, the testis is replaced by a gelatinous mass. Microscopically, a positive reaction for AFP is seen in tumor cells.
Radiographic features
Prospective radiologic characterization of yolk sac tumor is difficult, however a heterogeneous testicular mass favors non-seminomatous germ cell tumor (NSGCT), and at age <2 years, yolk sac tumor is the favored diagnosis.
Ultrasound
Diffusely enlarged heterogeneous testis.
MRI
Heterogeneous testicular mass lesion with post-contrast heterogeneous enhancement, with areas of hemorrhage/necrosis .
Treatment and prognosis
If the tumor is restricted to the testis, and if the serum AFP is not elevated, orchiectomy is the preferred treatment, with close follow-up. If relapse occurs, chemotherapy is the treatment of choice. The lungs are the most common site of recurrence.
See also
Siehe auch:
Assoziationen und Differentialdiagnosen zu Dottersacktumor des Hodens:
