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Published in: Pediatric Radiology 1/2014

01-01-2014 | Original Article

Yolk sac tumour: a rare cause of raised serum alpha-foetoprotein in a young child with a large liver mass

Authors: Annemieke S. Littooij, Kieran McHugh, M. Beth McCarville, Neil J. Sebire, Amita Bahrami, Derek J. Roebuck

Published in: Pediatric Radiology | Issue 1/2014

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Abstract

Background

Primary yolk sac tumour of the liver is extremely rare, and when it occurs in a young child it can be confused with hepatoblastoma.

Objective

To present a retrospective case series of primary hepatic yolk sac tumour from two institutions to highlight the imaging features.

Materials and methods

We conducted a retrospective review of pathological and imaging findings in biopsy-proven pure primary yolk sac tumour of the liver.

Results

A total of three children (15 months to 6 years) presented between 2006 and 2012 with primary hepatic yolk sac tumour. Two children presented with acute abdomen after minor trauma caused by tumour rupture and haemoperitoneum. We identified five additional paediatric cases of pure hepatic yolk sac tumour with descriptions of imaging findings in the literature. In seven of these eight children, central necrosis was seen on cross-sectional imaging.

Conclusion

Primary yolk sac tumour should be considered as an alternative diagnosis to hepatoblastoma in a young child with a large liver mass and significantly raised serum alpha-foetoprotein, but in view of the nonspecific imaging features histological examination is essential for diagnosis. Although there are no specific imaging findings of primary yolk sac tumour, presence of cystic or necrotic areas and a tendency for tumour rupture are suggestive features.
Literature
1.
go back to reference Ueno T, Tanaka YO, Nagata M et al (2004) Spectrum of germ cell tumors. From head to toe. Radiographics 24:387–404CrossRefPubMed Ueno T, Tanaka YO, Nagata M et al (2004) Spectrum of germ cell tumors. From head to toe. Radiographics 24:387–404CrossRefPubMed
2.
go back to reference Hart WR (1975) Primary endodermal sinus (yolk sac) tumor of the liver. First reported case. Cancer 35:1453–1458CrossRefPubMed Hart WR (1975) Primary endodermal sinus (yolk sac) tumor of the liver. First reported case. Cancer 35:1453–1458CrossRefPubMed
4.
go back to reference Warren M, Thompson KS (2009) Two cases of primary yolk sac tumor of the liver in childhood: case reports and literature review. Pediatr Dev Pathol 12:410–416CrossRefPubMed Warren M, Thompson KS (2009) Two cases of primary yolk sac tumor of the liver in childhood: case reports and literature review. Pediatr Dev Pathol 12:410–416CrossRefPubMed
5.
go back to reference Szucs RA, Narla LD (1992) Primary endodermal sinus tumor of the liver detected by CT. Pediatr Radiol 22:449–450CrossRefPubMed Szucs RA, Narla LD (1992) Primary endodermal sinus tumor of the liver detected by CT. Pediatr Radiol 22:449–450CrossRefPubMed
6.
go back to reference Gilbert KL, Bergman S, Dodd LG et al (2006) Cytomorphology of yolk sac tumor of the liver in fine needle aspiration: a pediatric case. Diagn Cytopathol 34:421–423CrossRefPubMed Gilbert KL, Bergman S, Dodd LG et al (2006) Cytomorphology of yolk sac tumor of the liver in fine needle aspiration: a pediatric case. Diagn Cytopathol 34:421–423CrossRefPubMed
7.
go back to reference Mokhallagh Sani P, Tarzamni MK, Aslanabadi S et al (2009) Pure yolk sac (endodermal sinus) tumor of the liver: a case report. Iran J Radiol 6:93–96 Mokhallagh Sani P, Tarzamni MK, Aslanabadi S et al (2009) Pure yolk sac (endodermal sinus) tumor of the liver: a case report. Iran J Radiol 6:93–96
8.
go back to reference Sizaret P (1979) Equivalence between international units and mass units of alpha-fetoprotein: report of a collaborative study. Clin Chim Acta 96:59–65CrossRef Sizaret P (1979) Equivalence between international units and mass units of alpha-fetoprotein: report of a collaborative study. Clin Chim Acta 96:59–65CrossRef
9.
go back to reference McCarville MB, Roebuck DJ (2012) Diagnosis and staging of hepatoblastoma: imaging aspects. Pediatr Blood Cancer 59:793–799CrossRefPubMed McCarville MB, Roebuck DJ (2012) Diagnosis and staging of hepatoblastoma: imaging aspects. Pediatr Blood Cancer 59:793–799CrossRefPubMed
10.
go back to reference Chan KL, Fan ST, Tam PK et al (2002) Management of spontaneously ruptured hepatoblastoma in infancy. Med Pediatr Oncol 38:137–138 Chan KL, Fan ST, Tam PK et al (2002) Management of spontaneously ruptured hepatoblastoma in infancy. Med Pediatr Oncol 38:137–138
11.
go back to reference Madanur MA, Battula N, Davenport M et al (2007) Staged resection for a ruptured hepatoblastoma: a 6-year follow-up. Pediatr Surg Int 23:609–611CrossRefPubMed Madanur MA, Battula N, Davenport M et al (2007) Staged resection for a ruptured hepatoblastoma: a 6-year follow-up. Pediatr Surg Int 23:609–611CrossRefPubMed
12.
go back to reference Von Schweinitz D (2006) Management of liver tumors in childhood. Semin Pediatr Surg 15:17–24CrossRef Von Schweinitz D (2006) Management of liver tumors in childhood. Semin Pediatr Surg 15:17–24CrossRef
Metadata
Title
Yolk sac tumour: a rare cause of raised serum alpha-foetoprotein in a young child with a large liver mass
Authors
Annemieke S. Littooij
Kieran McHugh
M. Beth McCarville
Neil J. Sebire
Amita Bahrami
Derek J. Roebuck
Publication date
01-01-2014
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 1/2014
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-013-2780-4

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