Salvage sacrococcygeal resection for yolk sac tumors after chemotherapy: report of 2 cases

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  • 1 Division of Pediatric Neurosurgery, Department of Surgery, Texas Children’s Hospital, Baylor College of Medicine;
  • 2 Division of Pediatric Surgery, Texas Children’s Surgical Oncology Program, M.E. DeBakey Department of Surgery, Baylor College of Medicine; and
  • 3 Department of Pathology and
  • 4 Texas Children’s Cancer Center, Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas
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Pediatric germ cell tumors (GCTs) are neoplasms that originate from primordial germ cells and, according to their site of presentation, are classified as gonadal or extragonadal. The most common site of extragonadal GCTs in children is the sacrococcygeal region, and the standard management is multimodal with a focus on chemotherapy. In selected instances, sacrococcygeal resection is performed. Herein, the authors report on 2 patients who presented with presacral yolk sac tumors managed with multimodal treatment. Both patients underwent salvage sacrococcygeal resection for oncological control and surgical removal of the sacral vertebral elements: a 27-month-old girl with a recurrent sacrococcygeal yolk sac tumor following chemotherapy and initial resection and a 24-month-old boy in whom a primary sacrococcygeal yolk sac tumor was resected following chemotherapy. These 2 cases illustrate the complexity in the management of these unusual tumors and will help neurosurgeons with the understanding of yolk sac tumors in the sacrococcygeal region.

ABBREVIATIONS AFP = alpha fetoprotein; BEP = bleomycin, etoposide, and cisplatin; EST = endodermal sinus tumor; GCT = germ cell tumor.

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Contributor Notes

Correspondence Guillermo Aldave: Texas Children’s Hospital, Houston, TX. gxaldave@texaschildrens.org.

INCLUDE WHEN CITING Published online October 4, 2019; DOI: 10.3171/2019.7.PEDS19321.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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