Neema Tiwari
Era’s Lucknow Medical College, India
Title: A rare presentation of pure yolk sac tumor in an undescended testis
Biography
Biography: Neema Tiwari
Abstract
Germ cell tumors are commonly encountered malignant tumors’ in adult males especially in the 20-40 year of age. They constitute one of the major leading causes of death in young males. Testicular tumors can be classified as seminomatous and non-seminomatous germ-cell tumor (NSGCT) types. Mixed germ cell tumors are known to contain more than one germ cell component and are much more common than any of the pure histological forms representing 32%-60% of all germ cell tumors. This was a case of germ cell tumor occurring in an undescended testis which was grossly a globular, encapsulated tissue piece measuring 15x9x7 cm. received. Outer surface shows two ruptures in the capsule with tumor tissue protruding out and few congested blood vessels on the surface. Cut surface was variegated, with tumor measuring 12x11 cm; within the tumor, areas of hemorrhage and spongoid areas are also seen.
Microscopy showed atypical cells lying in variable patterns. Large area of tumor is forming a reticular pattern having small cystic spaces lined by atypical cells with moderate pleomorphism , hyper chromatic nuclei coarse chromatin and prominent nucleoli with moderate amount of eosinophilic cytoplasm. Also seen were sheets of atypical cells with moderate pleomorphism, hyperchromasia coarse chromatin and prominent nucleoli. A foci of polyvesicular vitelline pattern having small cystic spaces with honeycombing also seen. Fair number of Schiller Duval Bodies with central vascular core filled with RBC with peripheral cuffing of atypical cells also seen admixed with large number of congested blood vessels , areas of haemorrhage and eosinophilic necrosis ,moderate chronic inflammatory infiltrate and foci of tumor autolysis. Histologically a pure germ cell tumor, Yolk sac tumor with five different patterns in one case is a rare finding for us. To the best of our knowledge such a presentation has not been seen in the last 10 years in our institute with less than 5 cases of germ cell tumor coming to our institute every year. The patient has been on monthly follow-up since then and is well.