Spinal cord compression of primary extragonadal giant yolk sac tumor.
METHODS
Case report.


OBJECTIVE
To report an adult male patient with a primary extragonadal giant yolk sac tumor presenting with acute spinal cord compression.


METHODS
Faculty of Medicine, University of Dicle, Diyarbakir, Turkey.


METHODS
A 31-year-old man was referred to our department with a diagnosis of Pott's disease, a complaint of back pain and gait difficulty for 2 weeks. Neurological examination showed spastic paraparesis and hypoesthesia below the L2 dermatome level. He also had urinary incontinence. Abdominal computed tomography and lumbar magnetic resonance imaging study revealed a giant cystic mass lesion located in the psoas muscle. Posteriorly, the third lumbar vertebral body was destructed and the tumor was compressing the dural sac. A combined anterior and posterior approach was performed. Pathological diagnosis was a yolk sac tumor.


RESULTS
His neurological status improved during the postoperative course. A chemotherapy protocol was given including bleomycin, etoposide and cisplatin. Five months after the last chemotherapy, he was brought to the emergency unit in sepsis and died despite antibiotherapy.


CONCLUSIONS
Yolk sac tumor should be considered in young adult male patients presenting with acute paraparesis even without any signs or medical history of a testis tumor. These tumors may be unresectable; however, decompression of neural structures and stabilization of the spine with instrumentation may cause substantial improvement in neurological deficit and pain relief.
Guzel
A
A
Department of Neurosurgery, University of Dicle, Diyarbakir, Turkey.
Tatli
M
M
Belen
D
D
Seckin
H
H
D000328:Adult; D019299:Decompression, Surgical; D018240:Endodermal Sinus Tumor / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008161:Lumbosacral Region / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D020335:Paraparesis / Q000209:etiology; D012186:Retroperitoneal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed