Alpha fetoprotein as marker for a case of orbital yolk sac tumour

Yolk sac tumours of the orbit and sinonasal tract

PURPOSE

The aim of this study is to report two cases of paediatric Yolk sac tumours (YST) of the orbit and sinonasal tract, with a major review on the subject.

METHODS

Two case reports along with a comprehensive retrospective literature review of all English language publications between 1974 and 2021 is presented. Literature review examined the demographics, clinical presentation and diagnostic and prognostic factors of extragonadal YSTs of the orbit and sinonasal tract.

RESULTS

Orbit and sinuses are rare sites for YST, with only 25 paediatric cases reported in the literature. Extragonadal yolk sac tumours carry a significantly worse outcome than those localised to the gonads, with the 5-year survival of 66% and 81-89%, respectively. Our review found the median age of presentation to be 18 months (18 months for males and 24 months for females), and females are more commonly affected. The most common presentations were proptosis, facial swelling and ophthalmoplegia. Treatments and therefore outcomes varied in the cases due to the large time period. Of the cases reported in the last 10 years, all patients with data provided were alive and disease-free at follow-up.

CONCLUSION

Sino-orbital yolk sac tumours are rare and have variable presentations, dependent on the extent of local invasion. Early diagnosis and treatment with multimodal therapy are paramount in having improved overall survival.

Primary orbital yolk sac tumor presenting as fungating mass

Primary yolk sac tumor of the orbit is a rare entity. Orbital involvement is usually seen in young children and proptosis is the commonest presentation. Aggressive orbital involvement and presentation as a fungating mass is rarely seen. We report a case of primary orbital yolk sac tumor with an aggressive presentation that responded well to systemic chemotherapy.

An intraocular yolk sac tumor in a child

PURPOSE

To report a case of intraocular yolk sac tumor (YST) misdiagnosed as retinoblastoma (RB) by several hospitals.

CASE REPORT

A 2-year-old girl presented to our hospital because of swelling and pain of her left eye for 2 months. The patient underwent an enucleation followed by chemotherapy. Pathologic and immunohistochemical examination of the specimen verified the diagnosis of YST. The patient underwent chemotherapy with the bleomycin, etoposide, and cisplatin regimen. At 1 year follow-up, our patient is in good health status.

CONCLUSIONS

In children, an intraocular tumor without calcification could be YST. Treatment options include enucleation and chemotherapy.

A case of intraocular yolk sac tumor in a child and its pathogenesis

While yolk sac tumor is one of the most common malignant germ cell tumors occurring in young children, it is rarely found in extragonadal sites. We report a case of intraocular yolk sac tumor in a 4-year-old boy. The diagnosis was confirmed by histologic examination and by the rapid normalization of serum alpha-fetoprotein level following enucleation. We propose that yolk sac cells can potentially migrate into the eye at 22 days of embryonic life during neural tube formation, when the head and tail of the neuropore open contemporaneously and communicate with the amniotic cavity.

Primary orbital endodermal sinus tumor (yolk sac tumor)

Endodermal sinus tumor, or yolk sac tumor, is the most common malignant neoplasm of germ cell origin and usually occurs in infant testes or ovaries. On rare occasions, the tumor may arise from extragonadal sites, including sacrococcygeal region, uterus, vagina, prostate, retroperitoneum, liver, mediastinum, pineal gland, and third ventricle. The orbit is an unusual location for the primary development of this neoplasm. We report the case of a girl with primary orbital endodermal sinus tumor who was managed with exenteration and chemotherapy with the result of a disease-free survival of 9 years.