Paediatric Imaging

Yolk cell tumour

(also called endodermal sinus tumour), a derivative of the primordial germ cell. Being multi-potential, this cell may give rise to a variety of structures that may be embryonic or extra-embryonic. The extra-embryonic tumours are divided into yolk sac tumour or choriocarcinoma. It is the commonest type of germ cell tumour in children and is found in 10 - 20% of sacrococcygeal teratomas. It is also found in the ovary ( Fig.1) and testes, and much less commonly in the mediastinum, pineal region, retroperitoneum and vagina. There is usually a raised alphafetoprotein. On imaging there are non-specific appearances and it appears as a space-occupying lesion in those various sites. See sacrococcygeal teratoma and testicular teratoma

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Fig.1

a. Abdominal radiograph of a girl aged 7 who presented with abdominal swelling. There is a paucity of bowel gas centrally within the abdomen, due to the large tumour. b. CT examination shows a huge tumour with mixed attenuation due to large areas of central necrosis. The tumour is displacing the bowel around it. The diagnosis was a malignant germ cell tumour.
Yolk cell tumour, Fig.1 (a)
Yolk cell tumour, Fig.1 (b)