Published in:
01-09-2016 | GI Image
Giant Primary Yolk Sac Tumor of the Liver
Published in: Journal of Gastrointestinal Surgery | Issue 9/2016
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A 39-year-old female with prior history of obesity and C-section developed right upper quadrant abdominal pain. She did not have fever, nausea and vomiting, or weight loss. Her pain was worse with deep breath but was not affected by food. She stopped taking birth control pills 14 years ago. Her BMI was 36.75. On physical exam, she had a large palpable mass in right upper quadrant. Her labs were prominent for Alpha-fetoprotein (AFP) 34.321 and Human chorionic gonadotropin (hCG) 22. A CT of the abdomen and pelvis with contrast showed a giant 25 cm solid heterogeneous mass in the right lobe of the liver (Fig. 1), and additional smaller masses in segments 4a and 5 measuring 4 and 3.5 cm, respectively (Fig. 2). All of the liver masses demonstrated peripheral and septal enhancement on the arterial and portal venous phases, which was highly suspicious for malignancy.
Fig. 1
CT abdomen with contrast, axial view, arterial phase. Large heterogeneous mass (yellow arrow) in the right hepatic lobe
Fig. 2
CT abdomen with contrast, coronal view, venous phase. Large heterogeneous mass (yellow arrow) in the right hepatic lobe. Two additional smaller lesions (red arrow) in segments 4a and 5
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