Successful treatment of non-midline primary malignant germ cell tumors with yolk sac components in neonates: report of 2 cases

Here, the authors present 2 cases of nongerminomatous germ cell tumor (NGGCT): a neonate with a mixed malignant germ cell tumor, 5% yolk sac tumor (YST) and 95% immature teratoma components, originating from the right mesial temporal lobe; and a 2-month-old infant with a pure YST originating from the left middle cranial fossa. These tumors with yolk sac components, which are thought to have a poor prognosis, were successfully treated with complete tumor resection alone and subtotal tumor resection with chemotherapy, respectively. Event-free survival exceeds 5 years for each patient even though neither received radiotherapy. The authors highlight the role of radical surgery and the successful treatment of neonatal YST with aggressive resection (and chemotherapy in 1 case) while avoiding radiation therapy. They also report the very rare non-midline location of these neonatal NGGCTs and emphasize the importance of considering YSTs and mixed NGGCTs with YST components in the differential diagnosis of non-midline hemispheric or skull base tumors in newborns.

Automated summary

The authors presented two cases of NGGCT in neonates, one with mixed malignant germ cell tumor and the other with pure YST. These tumors were successfully treated with either complete tumor resection or subtotal tumor resection with chemotherapy, resulting in event-free survival exceeding 5 years for both patients without the need for radiation therapy. The cases highlight the importance of radical surgery and successful treatment of neonatal YST, and emphasize the rare non-midline location of these tumors and the need to consider YSTs and mixed NGGCTs with YST components in the differential diagnosis of non-midline hemispheric or skull base tumors in newborns.