A. Wacker, F. Neunhoeffer, J. Fuchs, S. Warmann, C. Schwarze, K. Sotlar, H. Scheel-Walter, R. Handgretinger
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A yolk sac tumor in a female newborn with a subcutaneous metastasis of the abdominal wall
Extragonadal yolk sac tumors (YST) are extremely rare tumors. Only a few case reports can be found in the literature. We report about a female term newborn. After delivery a sacrococcygeal tumor was obvious. Alpha Fetoprotein (AFP) levels were in the upper normal range (91 006 ng/ml). The tumor was completely removed. Histological examinations revealed a typical YST. In the follow-up examinations a subcutaneous metastasis in the abdominal wall was found and excised at the age of 6 weeks. Curative polychemotherapy was induced. After 2 cycles AFP levels were decreased. However, the patient had a local relapse after the 4 cycle of chemotherapy and showed increased AFP levels. Therefore, hyperthermia combined with chemotherapy was applied and a second surgical resection was done. Despite of multiple therapy regime, the patient died due to tumor progress. This case demonstrates an uncommon dissemination of a primary YST. Therapeutic options in neonates are extremely difficult.