Primary Pediatric Yolk Sac Tumor of Liver With Lung Metastasis

An Unusual Presentation With Diagnosis Aided by LIN28 Immunohistochemistry

Sekar, Mithraa Devi MD
Pradeep, Immanuel MD
Srinivas, Bheemanathi Hanuman MD
Toi, Pampa Ch MD
Govindarajan, Krishnakumar MS, MCh
Kayal, Smita MD, DM

¹Department of Pathology, 29988Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
²Department of Pathology and Laboratory Medicine, 28730A.I.I.M.S., Bibinagar, Hyderabad, India
³Department of Pediatric Surgery, 29988Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
⁴Department of Medical Oncology, 29988Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India

Bheemanathi Hanuman Srinivas, Department of Pathology Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. Email: [email protected]

Received November 01, 2022

Received in revised form January 09, 2023

Accepted January 24, 2023

International Journal of Surgical Pathology 31(8):p 1618-1625, December 2023. | DOI: 10.1177/10668969231157777

Yolk sac tumor is a malignant germ cell tumor, which typically occurs in the gonads with elevated serum alpha-fetoprotein (AFP). Among extragonadal sites, the liver is an uncommon location for primary pediatric yolk sac tumors. Other common hepatic tumors in this age group presenting with elevated serum AFP like hepatoblastoma and hepatocellular carcinoma must be differentiated from yolk sac tumors for initiating appropriate treatment and accurate prognostication. Lung metastasis with refractoriness to chemotherapy is an extraordinary presentation that has never been documented in the literature. We report our experience with a 2-year-old female child initially misdiagnosed as hepatoblastoma. It was found that LIN28 positivity by immunohistochemistry aided in confirmation of the histopathological diagnosis of primary yolk sac tumor of the liver.