Shahid Majeed.
Yolk sac tumour of testis: A rare presentation in childhood.
Pak J Pathol Jan ;13(4):33-5.

A 1-1/2 year old boy reported in Surgical out door of PAF Hospital Sargodha on 24 May, 2003 with 04 months history of painless swelling of the right testicle. Swelling started insidiously and gradually increased to a considerable size. There was no history of mumps, trauma or urinary infection. On examination a firm, smooth surfaced, non tender, non fluctuant swelling of the right testicle, measuring 5x4 cm in size was palpable. Transillumination test was negative and upper limit of the swelling was approachable. Ultrasound showed a solid swelling of right testicle with no retroperitoneal and para aortic lymphadenopathy. X-ray chest revealed no abnormality. Alpha fetoprotein (AFP) was markedly raised (363 ng/ml as against normal range of <8), Beta human chorionic gonadotrophin (BHCG) was within normal limits and Lactic dehydrogenase (LDH) level was raised (673 u/I as against normal range of 160-480). Exploration of the swelling was performed, which revealed a smooth and solid mass (Fig 1). Soft clamp was applied to spermatic cord at the level of internal ring and orchidectomy was performed after transfixing the spermatic cord. Wound healing was satisfactory. Histopathology revealed mixed epithelial and mesenchymal elements, composed of glandular as well as alveolar pattern along with cystic spaces lined by endothelial like cells. Histopathological findings and raised marker levels confirmed the diagnosis of yolk sac tumour. The child was then referred to oncologist for further management.

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