Pineal yolk sac tumor
Synonyms and Keywords: Pineal yolk sac tumors; Pineal yolk sac tumour; Pineal yolk sac tumours; Pineal endodermal sinus tumor; Pineal endodermal sinus tumors; Pineal endodermal sinus tumour; Pineal endodermal sinus tumours; Pineal yolk sac carcinoma; Pineal yolk sac carcinomas; Pineal gland tumor; Germ cell tumor; Brain tumor
- Pineal yolk sac tumor is a rare type of extra gonadal yolk sac tumor. They make up a small fraction of all intracranial germ cell tumors and an even small fraction of pineal masses overall.
- Pure pineal yolk sac tumors secrete AFP.
- On microscopic histopathological analysis, pineal yolk sac tumor is characterized by poorly differentiated endothelium-like, cuboidal, or columnar cells with prominent nucleoli and significant mitotic activity.
- Pineal yolk sac tumor is demonstrated by positivity to tumor markers such as AFP, cytokeratin, and AAT. PAS-diastase positive hyaline globules and Schiller-Duval bodies are the characteristic features of pineal yolk sac tumors.
- In upto 50% of cases, these tumors co-exist with other germ cell tumors.
- Pineal yolk sac tumor may be associated with Down syndrome.
- Common complication of pineal yolk sac tumor includes obstructive hydrocephalus.
- Prognosis of pineal yolk sac tumor is generally poor.
- Symptoms of pineal yolk sac tumor include headache, nausea, vomiting, weakness, confusion, and somnolence.
- Head CT scan and brain MRI may be helpful in the diagnosis of pineal yolk sac tumor.
- On head CT scan, pineal yolk sac tumor is characterized by a hypodense, heterogenous mass in the pineal region with signs of obstructive hydrocephalus.
- On brain MRI, pineal yolk sac tumor is characterized by hypointensity on T1-weighted images and hyperintensity on T2-weighted images. There may be enhancement after contrast administration.
- Biopsy is generally done to confirm the diagnosis of pineal yolk sac tumor.
- The mainstay of therapy for pineal yolk sac tumor is radiotherapy and/or chemotherapy. Sometimes, surgical resection may be done.
- Pineal yolk sac tumour. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/pineal-yolk-sac-tumour. Accessed on December 8, 2015
- Davaus T, Gasparetto EL, Carvalho Neto Ad, Jung JE, Bleggi-Torres LF (2007). "Pineal yolk sac tumor: correlation between neuroimaging and pathological findings". Arq Neuropsiquiatr. 65 (2A): 283–5. PMID 17607429.
- Tan HW, Ty A, Goh SG, Wong MC, Hong A, Chuah KL (2004). "Pineal yolk sac tumour with a solid pattern: a case report in a Chinese adult man with Down's syndrome". J Clin Pathol. 57 (8): 882–4. doi:10.1136/jcp.2004.016659. PMC 1770394. PMID 15280413.
- Pathology of pineal yolk sac tumour. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/pineal-yolk-sac-tumour. Accessed on December 9, 2015
- Associations of pineal yolk sac tumor. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/pineal-yolk-sac-tumour. Accessed on December 8, 2015