Non-seminomatous extragonadal germ cell tumor (yolk sack tumor) in liver of a 17 years old patient with discrepancy in ultrasound and CT findings – a case report

Aim: To present a case of a 17 years old patient who appeared in the emergency unit with swollen abdomen.

Methods: The patient underwent abdominal ultrasound and CT scan. Abdominal ultrasound confirmed enlarged liver with multiple highly hyperechoic lesions which appeared solid, whereas abdominal CT confirmed multiple predominantly hypodense lesions, which appeared cystic. The lesions did not enhance on CT scan after contrast medium administration. An additional heterogenous mass was confirmed in the region around the tail of pancreas. Fine needle biopsy of liver suggested the diagnosis of a yolk sack tumor, whereas core needle biopsy found only necrotic material. The patient also had highly elevated AFP (22000ng/mL) and moderately elevated hCG (14000 iu/L). Liver probes were also moderately elevated. Urologic work up confirmed no testicular lesion.

Results: The patient was referred to the Oncology Department for chemotherapy. Since the core needle biopsy confirmed only necrotic material, results of further pathohistological analyses and the outcome of the therapy are still waited.

Conclusions: Extragonadal yolk sack tumor is a rare tumor of germ cell origin. Its hepatic involvement is even more unusual. The discrepancy in ultrasound and CT findings made this case exceptionally interesting. Further results of diagnostic tests and the outcome therapeutic measurements are still waited.