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.

Pathogenic implications of remnant vitelline structures in gastroschisis.

PURPOSE: The pathogenesis of gastroschisis is unknown. It may be helpful in understanding its pathogenesis to know the structural relationships among umbilical components including umbilical vessels, urachus, and vitelline structures, and thus, the authors investigated the remnants of vitelline structures in a series of cases of gastroschisis. METHODS: Medical records of 41 cases with gastroschisis treated in our institute from 1979 to 2009 were retrospectively reviewed. RESULTS: Paraumbilical bands, possible remnants of vitelline structures, were observed in 4 cases (9.8%). All 4 bands were attached to the skin edge of the abdominal defect without incorporation into the umbilical cord. The band ended at the mesentery in 3 cases and at the antimesenteric site of the ileum in the remaining case. Histologic findings showed fibrous tissues in all cases. One was possibly associated with the development of colonic atresia. Another was noticed after silo reduction when herniated bowels became strangulated by the band. The other 2 cases were uncomplicated. CONCLUSIONS: Our findings may support the recently proposed hypothesis that the developmental failure of the yolk sac and related vitelline structures to merge with or to be incorporated into the umbilical stalk might be associated with the pathogenesis of the abdominal wall defect in gastroschisis. Paraumbilical bands derived from vitelline structures may possibly cause intestinal ischemia prenatally or postnatally.

Influence of yolk on blood metabolites in perinatal and neonatal chickens.

Two experiments were conducted to assess the role of the yolk sac during the perinatal period (i.e., from embryonic Day 18 through hatch) and until 15 days after hatching. Experiment 1 describes changes in several yolk components. Approximately 70% of the yolk was absorbed during the perinatal period. Moisture, lipid, protein, and carbohydrate fractions were all utilized during this period. In Experiment 2, the age at which set-point physiological levels of several blood metabolites, as well as the magnitudes of these levels, in deutectomized (DT) chicks (surgical ablation of the yolk sac within 1 hr post-hatch) were not different from non-DT controls. Results indicate that the yolk sac plays a central role in the hatching process of chicks, rather than serving as a major metabolic reserve during the neonatal period.

Recognition and treatment of persistent omphalomesenteric ligament. A report of two cases.

Two patients undergoing diagnostic laparoscopy for chronic pelvic pain were discovered to have persistent omphalomesenteric ligaments. Excision was accomplished with Silastic banding and electrocauterization. These fibrous ligaments should be removed to relieve symptoms and to prevent other serious bowel complications.

[Experimental induction of teratoma in rats].

To induce an experimental teratoma, fetuses of Wistar strain rats were removed from the uterus, and the visceral yolk sac was left hanging through the fetectomy incision. After several weeks of this treatment, a tumor developed in these animals with or without both side oophorectomy. Despite the fact that the visceral yolk sac is composed of endoderm and mesoderm, the tissues in the resulting tumor obtained from the ectopically implanted yolk sac showed derivatives from all three germ layers, including skin, bone, gut and nervous tissues. Changes in hormonal environment induced by oophorectomy did not affect the process of experimental tumor induction. When 7,12-dimethylbenz-(a)-anthracene (DMBA) was directly applied to the yolk sac at the fetectomy, a neoplasm mainly consisted of yolk sac elements was investigated after two to four months of the treatment. From the results of this experiment, it was seemed that an embryonic and extraembryonic teratomatous tumor might have been derived from the visceral yolk sac.