Korean J Radiol.  2014 Oct;15(5):641-645. 10.3348/kjr.2014.15.5.641.

CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

• Lin S
• Li X
• Sun C
• Feng S
• Peng Z
• Huang S
• Li Z

• KMID: 1734950
• DOI: http://doi.org/10.3348/kjr.2014.15.5.641

Abstract

Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.

Keyword

Computed tomography; Kidney; Yolk sac tumor; Tumor thrombus; Inferior vena cava; Renal vein

MeSH Terms

Child, Preschool
Humans
Male
Neoplasms, Germ Cell and Embryonal/*diagnosis/pathology/ultrasonography
Renal Veins/pathology/*radiography
Thrombosis/pathology/radiography
*Tomography, X-Ray Computed
Vena Cava, Inferior/pathology/*radiography

Figure

• 

  Fig. 1 Intrarenal YST with intravascular involvement in 2-year-old boy. A. Color Doppler shows large, heterogeneous mass with marked intralesional flow in left kidney. B. Contrast-enhanced CT scan shows necrotic solid mass with multiple enlarged vessels (short arrows). Extension of lesion into IVC is noted (long arrow). C. Contrast-enhanced CT scan shows two tumor nodules (arrows) with enhancing rim within renal parenchyma. D. Excretory-phase CT scan shows tumor growing around calices (arrows), which are narrowed or obliterated. IVC = inferior vena cava, YST = yolk sac tumor. E. Photomicrograph shows papillary structures that consist of columnar tumor cells, surrounding glumeruloid blood vessels (Schiller-Duval body, arrows) (hematoxylin and eosin, × 200). F. Postcontrast CT scan shows marked reduction in size of mass after chemotherapy. Tumor extending into left renal vein is noted (arrow). G. Gross specimen shows variegated cut surface and multiple tumor lobules with central hemorrhage. Tumor is encasing and infiltrating collecting system, which is consistent with CT findings. YST = yolk sac tumor

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