Thoracic spine fracture secondary to anterior mediastinal yolk sac germ cell tumor: A case report and a brief review

Fractura de columna toracica secundaria a tumor de c ´ elulas germinativas del saco vitelino ´ del mediastino anterior: reporte de un caso y breve revision

Resumen

Yolk Sac Germ Cell Tumors (GCT) are rare nonseminomatous tumors. When yolk sac tumors (YST) are primarily from the anterior mediastinum, they may be asymptomatic for an extended period with a bad prognosis. Some tumor markers, such as cytokeratins, OCT 3/4, SALL-4, and alpha-fetoprotein (AFP), are essential for diagnoses. Diagnosis is based on imaging, immunohistochemistry, and the presence of tumor markers. In YST, beta-human chorionic gonadotropin hormone is negative. Treatment is adjuvant cisplatin-based chemotherapy and surgery.

The critical point of this article is to demonstrate how the evolution of a mediastinal tumor can cause an acute neurological condition, in this case, transversal myelitis, which sometimes requires support in the intensive care unit.

We described a rare clinical case of primary YST of the anterior mediastinum clinically presented as pneumonia followed by the completed medullary syndrome. We included a complete review of this tumor and discussed the medullary compromise to increase the medical knowledge and suspicion of lectors. Prompt treatment of medullary syndrome and tumor characterization is critical to definitive treatment and prognosis estimation.