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Intracardiac yolk sac tumor in an infant girl
M Graf1, H Blaeker, P Schnabel
1Institute of Pathology, University of Heidelberg, Germany.
Insights
A rare primary cardiac yolk sac tumor (YST) was diagnosed in a young girl. This finding is novel, as no similar intracardiac YST cases have been previously reported in medical literature.
Area of Science:
- Pediatric Oncology
- Cardiovascular Pathology
- Surgical Oncology
Background:
- Primary cardiac tumors are rare in children.
- Yolk sac tumors (YSTs) are germ cell tumors typically found in gonads or extragonadal sites.
Observation:
- A two-and-a-half-year-old girl presented with a systolic cardiac murmur.
- Echocardiography revealed a large tumor on the interventricular septum, occupying over half the left ventricle.
- Diagnosis was confirmed via surgical biopsy and elevated serum alpha-fetoprotein (AFP) levels.
Findings:
- Histopathological examination confirmed a primary yolk sac tumor (YST) of the heart.
- Post-surgical imaging (CT scans) ruled out extracardiac tumor manifestations.
- This represents the first reported case of a primary intracardiac yolk sac tumor.
Implications:
- Highlights the possibility of rare cardiac tumor presentations in pediatric patients.
- Emphasizes the importance of considering YST in the differential diagnosis of pediatric cardiac masses with elevated AFP.
- Contributes to the limited literature on primary cardiac germ cell tumors, aiding future diagnosis and management.
Abstract:
We report about a two and a half year old girl with a primary yolk sac tumor (YST) of the heart, located in the interventricular septum. The girl was admitted to the hospital with a systolic cardiac murmur. Echocardiography revealed a smoothly surfaced tumor which based on the interventricular septum below the aortic valve and filled out more than half of the left ventricular cavity. Diagnosis of a yolk sac tumor was established on a frozen section of a biopsy taken at surgery and confirmed by the examination of the resected material. Excessively elevated serum alpha-fetoprotein (AFP) levels contributed to this diagnosis. Follow up examinations of the patient including computed tomography (CT) of head, thorax and abdomen, did not indicate an extracardiac tumor manifestation. We found no previous report of a primary intracardial yolk sac tumor in the literature.