Krebswissenschaft und -therapie

Spinal Cord Compression Caused by Metastasis of a Non-Seminomatous Testicular Tumour with a Predominant Yolk Sac Component in a 26-YearOld Man

Abstract

Di Gregorio D, Pochet C, Dupont M, Nollevaux MC, Lorge F and D'Hondt L

Background: Pure testicular yolk sac tumours are extremely rare among adults, and there is no prior report of spinal cord compression syndrome due to yolk sac testis tumour metastasis in an adult.

Case presentation: Here we describe the case of a 26-year-old male with a testicular yolk sac tumour that was found when a vertebral metastasis caused spinal cord compression. Symptoms included lower back pain and a growing painless testicular mass. Treatment comprised emergency surgical spinal cord decompression and orchidectomy, followed by 3 cycles of bleomycin, etoposide, and platinum (BEP) chemotherapy, and then 3 cycles of etoposide and platinum and 40 Gy vertebral radiotherapy. One year later, cement leaked into the spinal duct, prompting a return of compression syndrome. Corporectomy was performed, followed by osteosynthesis. The patient’s treatment was consolidated with 34 months and zoledronic acid administration. Although spinal metastasis from a yolk sac tumour is extremely rare, it must be considered in young adults with a testicular mass who exhibit pain or limb numbness. Such cases warrant rapid surgical decompression and radical orchidectomy, followed by adjuvant chemotherapy.

Conclusion: Our case is atypical due to the patient’s age and the disease presentation. Spinal cord compression syndrome caused by yolk sac tumor metastasis is extremely rare in adulthood, and usually has a bad prognosis when diagnosed late.