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Giant Primary Hepatic Endodermal Sinus Tumor: Multidisciplinary Management and Long-Term Survival
Katia Roque1,2,3, Rossana Ruiz1, Renier Cruz4
1Department of Medical Oncology, National Institute of Neoplastic Diseases (INEN), Lima, Peru.
Case Reports in Oncological Medicine
|January 12, 2026
Summary
Primary hepatic endodermal sinus tumors (ESTs), or yolk sac tumors, are rare but treatable. This case highlights successful management of a hepatic EST mimicking HCC, achieving long-term survival with chemotherapy.
Area of Science:
- Oncology
- Pathology
Background:
- Endodermal sinus tumors (ESTs), also known as yolk sac tumors, are a type of germ cell tumor.
- While typically gonadal, 1%-5% of ESTs occur extragonadally, with primary hepatic EST being exceptionally rare.
Purpose of the Study:
- To present a case of primary hepatic endodermal sinus tumor (EST) in a young woman.
- To discuss the diagnostic challenges and successful management of this rare condition.
Main Methods:
- Case report of a 34-year-old woman with a hepatic mass and elevated alpha-fetoprotein (AFP).
- Initial misdiagnosis as hepatocellular carcinoma (HCC) leading to surgery.
- Post-operative chemotherapy (BEP and EP) and follow-up imaging (PET CT).
Main Results:
- Pathology confirmed primary hepatic EST after hepatectomy.
- Chemotherapy resulted in a complete response, with no evidence of disease at over 5 years.
- The patient remains clinically stable with negative tumor markers.
Conclusions:
- Primary hepatic EST is a rare but crucial differential diagnosis for hepatic masses, especially in young women with elevated AFP.
- Early biopsy and multidisciplinary care are vital for managing this chemosensitive tumor.
- Timely systemic treatment can lead to long-term survival.
