Primary yolk sac tumor of the liver: incidental finding in a patient transplanted for hepatocellular carcinoma.
A 64-year-old man with HBV-related cirrhosis presented with a liver nodule measuring 2.8 cm revealed by a routine ultrasound and concomitant increased alpha-fetoprotein (AFP) up to 400 UI/l. Contrast-enhanced CT was suggestive of hepatocellular carcinoma (HCC) and the patient underwent laser ablation procedure. Five months later, because of raised AFP up to 1600 UI/l, ultrasonography and abdominal CT were repeated, showing an increased diameter of liver nodule, measuring 3.8 cm. The patient underwent down-staged trans-arterial chemoembolization (TACE) and then was entered into the active liver transplant (LT) list. Lamivudine was already started and the patient underwent LT showing HBV-DNA serum levels <10(3) log/copies at the time of surgery. Pathological analysis performed on the explanted liver showed, instead of the suspected HCC, hepatic yolk sac tumor with the presence of typical 'Schiller-Duval bodies'. The first 12 months of postoperative follow-up were excellent, with no evidence of tumor recurrence.
Lenci
Ilaria
I
Department of Internal Medicine, Liver Transplant Centre, Tor Vergata University, Rome, Italy. ilaria.lenci@uniroma2.it
Tariciotti
Laura
L
Baiocchi
Leonardo
L
Manzia
Tommaso Maria
TM
Toti
Luca
L
Craboledda
Paolo
P
Callea
Francesco
F
Angelico
Mario
M
Tisone
Giuseppe
G
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D003951:Diagnostic Errors; D018240:Endodermal Sinus Tumor / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged