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.
Similar content being viewed by others
References
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 17:100
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 77:173–176
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 34:345–351
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 85:988–997
Gupta K, Karthigeyan M, Kumar N, Salunke P (2016) ‘Changing colors’ of third ventricular tumor in a young woman. Neuropathology 37:282–285
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 86:446–455
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 32:275–280
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 24:387–404
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Gupta, K., Karthigeyan, M., Satapathy, A. et al. Synchronous solitary calvarial yolk sac tumor metastasis as the initial presentation of mediastinal germ cell tumor. Childs Nerv Syst 34, 363–366 (2018). https://doi.org/10.1007/s00381-017-3618-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-017-3618-4