A subcutaneous paraspinal yolk sac tumor in a child.

A 3-year-old girl underwent a surgery at an external center on July 2011 for a swelling in the left lumbar paravertebral subcutaneous region. The mass was completely excised and the pathologic diagnosis was a yolk sac tumor (YST). Laboratory tests revealed a serum α-fetoprotein level of 278 IU/mL. Investigations using bone scintigraphy and magnetic resonance imaging revealed a scar tissue at the surgical site and lesions indicating metastasis at the lumbar first, second, third, and fifth vertebra. The patient was administered 5 cycles of PEB (cisplatin, etoposide, bleomycin) treatment. The serum α-fetoprotein was 3 IU/mL after the treatment. The lumbar magnetic resonance imaging and bone scintigraphy results were normal. The patient continues to be in remission since June 2012. YSTs are most commonly seen in the testis, ovary, and sacrococcygeal regions. Atypical locations have been reported with the primary lesion in the stomach, diaphragm, omentum, sino-nasal region, cranial base, lungs, vagina, and penis. Our case is probably a YST with an atypical location derived from preliminary cells left under the skin because of a migration defect.

A rare type of secondary cancer in a child with acute lymphoblastic leukemia: malignant fibrous histiocytoma.

Secondary cancers which are related with treatment of childhood acute lymphoblastic leukemia (ALL) is a significant problem with longer term. For development of secondary cancer after treatment, the latency period varies between 5 and 10 years. In this case, a 13 year-old-boy diagnosed as high-risk ALL was treated with chemotherapy and prophylactic cranial radiotherapy at a dose of 1800 cGy. Six years after the end of treatment he developed a 5 × 5 × 4 cm mass at the right temporal region of the cranium. The mass was excised totally with clear surgical margin. Pathology of mass has been diagnosed as malignant fibrous histiocytoma (MFH), recently referred to as an undifferentiated pleomorphic sarcoma (UPS). After treatment of childhood ALL, reported cases of secondary MFH is extremely rare in the literature. Herein we present a case of MFH/UPS that developed as a secondary cancer 6 years after the end of ALL treatment.