Hosting 708 files, 2884 images, and 4 contributors.

 
Random Case

Bile Leak after Blunt Liver Injury
Joseph Junewick, MD FACR
over 4 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Mixed Germ Cell Neoplasm

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 5 years ago
Updated: over 3 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
Adobe32 PDF Imagej32 ImageJA

History

8 month old with perineal swelling and erythema.


Case Images


Diagnosis

Mixed germ cell neoplasia (98% malignant yolk sac tumor, 2% mature teratoma)

Clinical Notes

Markedly elevated serum alpha fetoprotein level.

Findings

MRI – Sagittal FSE2, axial T1, axial FS FSE2 and coronal FS post-gadolinium T1 images reveal an enhancing mixed signal macrolobulated presacral pelvic mass. Note that the coccyx is engulfed by the mass.

Discussion

Germ cell tumors occur in 1 out of 30000 to 70000 live births and occur in females four times as often as males. Abnormal differentiation of fetal germ cells give rise to germ cell tumors. Migration patterns determine the site of tumor development; sacrococcygeal > ovary > testicle> brain > mediastinum > neck. Sacrococcygeal germ cell tumors are congenital. The earlier the diagnosis is made the better the prognosis; external lesions are easily diagnosed at birth or by prenatal imaging but internal lesion diagnosis is often delayed. Survival and risk of recurrence is related to maturity of the germ cells.

Reference

Schey WL, Shkolnik A, and White H. Clinical and Radiographic Considerations of Sacrococcygeal Teratomas: An Analysis of 26 New Cases and Review of the Literature. Radiology (1977); 125:189-195.



Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare