Advertisement

Child's Nervous System

, Volume 34, Issue 2, pp 363–366 | Cite as

Synchronous solitary calvarial yolk sac tumor metastasis as the initial presentation of mediastinal germ cell tumor

  • Kirti Gupta
  • Madhivanan KarthigeyanEmail author
  • Ayushman Satapathy
  • Pravin Salunke
Case Report

Abstract

Introduction

In children, malignant tumors presenting as a calvarial mass that too as initial manifestation are unusual. Also, brain metastases per se are rare in pediatric solid tumors with an incidence of just 1.5%.

Case description

We present a child with calvarial metastasis which was the presenting symptom of an otherwise asymptomatic large malignant mediastinal germ cell tumor (GCT). The lesion was dural-based involving both calvaria as well as the underlying brain parenchyma. Despite such multicompartmental location, no obvious bony destruction was seen. A 12-year-old boy presented with progressively enlarging scalp swelling and features of raised intracranial pressure. The lesion was totally excised and calvarial defect reconstructed using titanium mesh. Though the preoperative chest computed tomography suggested teratoma, the histopathology of the cranial lesion was a yolk sac tumor (YST).

Conclusion

Initial manifestation of GCT as calvarial swelling, pure YST (with no other germ cell component), and the eccentric multicompartmental (dural based) location rather than usual midline GCTs is noteworthy. The report thus highlights an atypical presentation in GCT. Although uncommon, it is worthwhile to consider metastatic GCT as a differential among calvarial lesions.

Keywords

Yolk sac tumor Germ cell tumor Teratoma Brain metastasis Mediastinal germ cell tumor Calvarial 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Chargari C, MacDermed D, Védrine L (2010) Symptomatic solitary skull bone metastasis as the initial presentation of a testicular germ cell tumor. Int J Urol 17:100CrossRefGoogle Scholar
  2. 2.
    Cheon HC, Jung S, Moon KS, Lee MC, Kim IY, Jung TY, Kim SH, Kang SS (2006) Primary endodermal sinus tumor of the cerebellar hemisphere: a case report with review of the literature. J Neuro-Oncol 77:173–176CrossRefGoogle Scholar
  3. 3.
    Feldman DR, Lorch A, Kramar A, Albany C, Einhorn LH, Giannatempo P, Necchi A, Flechon A, Boyle H, Chung P, Huddart RA, Bokemeyer C, Tryakin A, Sava T, Winquist EW, De Giorgi U, Aparicio J, Sweeney CJ, Cohn Cedermark G, Beyer J, Powles T (2016) Brain metastases in patients with germ cell tumors: prognostic factors and treatment options—an analysis from the Global Germ Cell Cancer Group. J Clin Oncol 34:345–351CrossRefGoogle Scholar
  4. 4.
    Fosså SD, Bokemeyer C, Gerl A, Culine S, Jones WG, Mead GM, Germa-Luch JR, Pont J, Schmoll HJ, Tjulandin S (1999) Treatment outcome of patients with brain metastases from malignant germ cell tumors. Cancer 85:988–997CrossRefGoogle Scholar
  5. 5.
    Gupta K, Karthigeyan M, Kumar N, Salunke P (2016) ‘Changing colors’ of third ventricular tumor in a young woman. Neuropathology 37:282–285CrossRefGoogle Scholar
  6. 6.
    Matsutani M, Sano K, Takakura K, Fujimaki T, Nakamura O, Funata N, Seto T (1997) Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 86:446–455CrossRefGoogle Scholar
  7. 7.
    Tashiro R, Kanamori M, Suzuki H, Utsunomiya A, Meguro K, Uenohara H, Tominaga T (2015) Diffuse large B cell lymphoma of the cranial vault: two case reports. Brain Tumor Pathol 32:275–280CrossRefGoogle Scholar
  8. 8.
    Ueno T, Tanaka YO, Nagata M, Tsunoda H, Anno I, Ishikawa S, Kawai K, Itai Y (2004) Spectrum of germ cell tumors: from head to toe. Radiographics 24:387–404CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Kirti Gupta
    • 1
  • Madhivanan Karthigeyan
    • 2
    Email author
  • Ayushman Satapathy
    • 2
  • Pravin Salunke
    • 2
  1. 1.Department of HistopathologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
  2. 2.Department of NeurosurgeryPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

Personalised recommendations