Yolk Sac TumorMasquerading AsPericarditis: A Case Report

Abstract

Introduction:Yolk sac tumor is a rare form of a germ cell tumor (GCT).This case report describes an unusual presentation of a yolk sac tumor with pericarditis, pericardial effusionand bilateral microlithiasis (MT) in a young Vietnamese male with extragonadal GCT in the anterior mediastinum. Presentation of Case:A 23-year-old Vietnamese male with one-pack year smoking history, but no other significant past medical history presented with nonproductive cough and pleuritic chest pain for 2 weeks. Chest pain was described as sharp and localized to the right-side of his substernal area. B-symptoms were present for 1 month and included: weight loss of 10lbs, night sweats and fever.Physical exam showeddiminished breath sounds on the right side of the chest w/o accessory muscle use. CT of the chest revealed a large 14 cm round mass in the right middle lobe with possible extension to the mediastinum, moderate right pleural effusion and pericardial effusion.EKG showed a pattern consistent with pericarditis. Biopsy of the mediastinal mass was consistent with yolk sac tumor. LDH was 543, AFP 7200, and β-HCG2.Testicular ultrasound did not find any testicular masses, but there was bilateral testicular microlithiasis. The patient was started on BEP (Bleomycin + Etoposide + Cisplatin) chemotherapy with subsequent thoracotomy and mass resection.Conclusion:Younger patients presenting with pleural effusions and pericarditis need a detailed history and physical examination in order to diagnosea yolk sac tumor