Rare Intracranial Yolk Sac Tumor in Basal Ganglia Treatment

An adult male presented with an intracranial yolk sac tumor (YST) that initially manifested as abnormal signals in the right basal ganglia on MRI, misdiagnosed as a cavernous hemangioma. Within two years, the condition progressed into a hypervascular solid neoplasm causing basal ganglia hemorrhage. Various evaluations confirmed the YST diagnosis, leading to surgical resection, radiotherapy, and chemotherapy. The patient’s stable condition post-treatment highlights the importance of early diagnosis to prevent misinterpretation of benign-appearing lesions as malignant infiltrations.

YSTs typically arise in the gonads but can also occur extragonadally, with primary intracranial YSTs being rare. This case study sheds light on the unique presentation of an intracranial YST in the basal ganglia, emphasizing the importance of thorough diagnostic evaluation and timely treatment. The pineal gland and suprasellar region are more common sites for intracranial germ cell tumors, making YSTs in the basal ganglia a seldom-documented occurrence.

The patient, a 22-year-old male, presented with headache, vomiting, and left upper limb weakness, leading to the discovery of a YST in the right basal ganglia. Initial MRI findings indicated a cavernous hemangioma, but subsequent imaging revealed a hemorrhagic hypervascular tumor necessitating surgical intervention. The case highlights the challenge of diagnosing rare intracranial tumors and the need for a multidisciplinary approach to treatment.

Surgical resection of the YST in the basal ganglia was followed by radiotherapy and chemotherapy, resulting in the patient’s stable condition six months post-treatment. The case underscores the importance of accurate diagnosis and comprehensive treatment strategies for intracranial tumors, particularly those with atypical presentations like YSTs in the basal ganglia. Continued research is crucial to enhance diagnostic methods and treatment outcomes for such rare malignancies.

The histopathological examination of the tumor revealed characteristic features of YST, including Schiller–Duval bodies and immunohistochemical markers such as AFP, CK, PLAP, and SALL4. Molecular genetic analysis identified somatic genomic variations associated with tumor progression, highlighting the potential for targeted therapies in the future. The patient’s response to radiotherapy and chemotherapy underscores the significance of personalized treatment approaches in managing intracranial YSTs.

In conclusion, this case report provides valuable insights into the diagnosis and treatment of intracranial YSTs, particularly in unusual locations like the basal ganglia. The successful outcome post-surgery, radiotherapy, and chemotherapy underscores the importance of early detection and comprehensive management of rare intracranial tumors. Further research into the molecular mechanisms of YSTs is essential to improve treatment strategies and patient outcomes in the future.