Indian Journal of Urology
CASE REPORT
Year
: 2017  |  Volume : 33  |  Issue : 2  |  Page : 167--168

Primary intrarenal yolk sac tumor


Narasimhan Ragavan1, P Dholakia Kunal1, S Annapurneshwari2,  
1 Department of Uro-oncology, Apollo Hospital, Chennai, Tamil Nadu, India
2 Department of Pathology, Apollo Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
P Dholakia Kunal
Department of Uro-oncology, Apollo Hospital, Chennai, Tamil Nadu
India

Abstract

Extragonadal germ cell tumors (EGGCTs) usually are not coexistent with a gonadal tumor, hence in a way, are primary and are rare. The origin of primary EGGCT is still a matter of debate. Herewith, we report a patient with primary intrarenal yolk sac tumor in a 43-year-old man. The purpose of this report is to add a rare tumor to the differential diagnosis of renal neoplasms.



How to cite this article:
Ragavan N, Kunal P D, Annapurneshwari S. Primary intrarenal yolk sac tumor.Indian J Urol 2017;33:167-168


How to cite this URL:
Ragavan N, Kunal P D, Annapurneshwari S. Primary intrarenal yolk sac tumor. Indian J Urol [serial online] 2017 [cited 2022 Jun 28 ];33:167-168
Available from: https://www.indianjurol.com/text.asp?2017/33/2/167/203410


Full Text



 Introduction



Yolk sac tumor (endodermal sinus tumor) (YST) is a malignant germ cell tumor that usually arises in the gonads. Rare occurrence of extragonadal germ cell tumors is known to occur in the mediastinum, retroperitoneum, sacrococcygeal region, and pineal gland.[1] We report an isolated intrarenal YST in an adult who presented with a renal mass.

 Case Report



A 43-year-old male presented with left upper abdominal pain, mildly tender palpable mass, normal genitals, and unremarkable previous surgical issues. Imaging revealed bilateral renal calculi along with grossly enlarged, calculi laden, hydronephrotic left kidney, intrarenal mass lesion of renal pelvis, and perinephric stranding. Multiple enlarged necrotic retroperitoneal nodes were noted [Figure 1].{Figure 1}

With the clinical suspicion of xanthogranulomatous pyelonephritis with squamous metaplasia/carcinoma, open left radical nephrectomy, and excision of palpable retroperitoneal nodes was performed.

Histopathological examination revealed high-grade malignant germ cell tumor with features favoring for YST (Schiller-Duval body, microcytic, and solid pattern along with hyaline globules stained dark pink on D-PAS stain) with positive metastatic nodes. Immunohistochemistry confirmed YST (alpha-fetoprotein [AFP], cytokeratin, placental-like alkaline phosphatase, CD30, glypican 3 positivity and negative for c-kit and beta-human chorionic gonadotropin [HCG]) [Figure 2]. Subsequent scrotal ultrasonography did not show echogenicity/scars. Serum AFP levels of 2640 ng/mL with normal beta-HCG and lactate dehydrogenase levels. The patient has been advised adjuvant chemotherapy.{Figure 2}

 Discussion



Extragonal YST is rare and intrarenal tumor has been reported in pediatric age group.[2],[3],[4],[5] To the best of our knowledge, this is the first reported case of an intrarenal YST in adults. The purpose of this report is to add a rare tumor to the differential diagnosis of renal neoplasms.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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