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Vaginal endodermal sinus tumor in an infant: a case report ; Tumor de seno endodérmico vaginal en una lactante: reporte de un caso

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Title: Vaginal endodermal sinus tumor in an infant: a case report ; Tumor de seno endodérmico vaginal en una lactante: reporte de un caso
Authors: Borja-Zapata, Boris, Cruzado-Villanueva, Carla, Borja-Urbano, Georgette
Source: Investigación e Innovación Clínica y Quirúrgica Pediátrica; Vol. 3 No. 2 (2025); 34-38 ; Investigación e Innovación Clínica y Quirúrgica Pediátrica; Vol. 3 Núm. 2 (2025); 34-38 ; 2961-2543 ; 2961-2535 ; 10.59594/iicqp.2025.v3n2
Publisher Information: Instituto Nacional de Salud del Niño San Borja
Publication Year: 2025
Subject Terms: Endodermal Sinus Tumor, Vaginal Discharge, Vaginal Neoplasms, Magnetic Resonance Imaging, Case Reports, Tumor del Seno Endodérmico, Excreción Vaginal, Neoplasias Vaginales, Imagen por Resonancia Magnética, Informe de caso
Description: Background: Endodermal sinus tumor is a malignant germ cell neoplasm, most commonly of gonadal origin. Its occurrence in the vagina is extremely rare. Case description: We report the case of a 7-month-old infant presenting with intermittent vaginal discharge and bleeding for 3 months. Initial ultrasound revealed a vascularized hypoechoic lesion located in the upper vaginal canal. Laboratory tests showed elevated serum alpha-fetoprotein levels (range: 1,415–2,500 ng/mL). Subsequent magnetic resonance imaging identified a solid tumor in the upper third of the vaginal canal, with mass effect on adjacent structures, avid heterogeneous contrast enhancement, diffusion restriction, and no evidence of regional infiltration. Histopathological analysis of an expelled vaginal blood clot confirmed the diagnosis of endodermal sinus tumor with Schiller-Duval bodies. The patient underwent six cycles of chemotherapy with bleomycin, etoposide, and cisplatin over 6 months, without clinical complications. Follow-up imaging 3 months after completion of treatment showed a reduction in tumor size and no evidence of intra- or extrapelvic metastases. Alpha-fetoprotein levels progressively decreased. A subsequent biopsy was negative for malignant neoplasia. Conclusion: Vaginal endodermal sinus tumor represents an extremely rare extragonadal presentation, primarily observed in infancy. Imaging plays a crucial role in the diagnosis, follow-up, and therapeutic planning of this entity. ; Antecedentes: El tumor de seno endodérmico es una neoplasia maligna de células germinales, habitualmente gonadal. Su localización vaginal es excepcional. Descripción del caso: Se presenta el caso de una lactante de 7 meses de edad con flujo y sangrado vaginal intermitente de 3 meses de evolución. La ecografía inicial reveló una lesión hipoecogénica vascularizada ubicada en el canal vaginal superior. Los estudios de laboratorio revelaron niveles séricos elevados de alfa fetoproteína (rango: 1 415 – 2 500 ng/mL). Posteriormente, la resonancia magnética ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: Spanish; Castilian
Relation: https://investigacionpediatrica.insnsb.gob.pe/index.php/iicqp/article/view/142/202; https://investigacionpediatrica.insnsb.gob.pe/index.php/iicqp/article/view/142/216; https://investigacionpediatrica.insnsb.gob.pe/index.php/iicqp/article/view/142
Availability: https://investigacionpediatrica.insnsb.gob.pe/index.php/iicqp/article/view/142
Rights: Derechos de autor 2025 Investigación e Innovación Clínica y Quirúrgica Pediátrica ; https://creativecommons.org/licenses/by/4.0
Accession Number: edsbas.744E5F89
Database: BASE
Description
Abstract:Background: Endodermal sinus tumor is a malignant germ cell neoplasm, most commonly of gonadal origin. Its occurrence in the vagina is extremely rare. Case description: We report the case of a 7-month-old infant presenting with intermittent vaginal discharge and bleeding for 3 months. Initial ultrasound revealed a vascularized hypoechoic lesion located in the upper vaginal canal. Laboratory tests showed elevated serum alpha-fetoprotein levels (range: 1,415–2,500 ng/mL). Subsequent magnetic resonance imaging identified a solid tumor in the upper third of the vaginal canal, with mass effect on adjacent structures, avid heterogeneous contrast enhancement, diffusion restriction, and no evidence of regional infiltration. Histopathological analysis of an expelled vaginal blood clot confirmed the diagnosis of endodermal sinus tumor with Schiller-Duval bodies. The patient underwent six cycles of chemotherapy with bleomycin, etoposide, and cisplatin over 6 months, without clinical complications. Follow-up imaging 3 months after completion of treatment showed a reduction in tumor size and no evidence of intra- or extrapelvic metastases. Alpha-fetoprotein levels progressively decreased. A subsequent biopsy was negative for malignant neoplasia. Conclusion: Vaginal endodermal sinus tumor represents an extremely rare extragonadal presentation, primarily observed in infancy. Imaging plays a crucial role in the diagnosis, follow-up, and therapeutic planning of this entity. ; Antecedentes: El tumor de seno endodérmico es una neoplasia maligna de células germinales, habitualmente gonadal. Su localización vaginal es excepcional. Descripción del caso: Se presenta el caso de una lactante de 7 meses de edad con flujo y sangrado vaginal intermitente de 3 meses de evolución. La ecografía inicial reveló una lesión hipoecogénica vascularizada ubicada en el canal vaginal superior. Los estudios de laboratorio revelaron niveles séricos elevados de alfa fetoproteína (rango: 1 415 – 2 500 ng/mL). Posteriormente, la resonancia magnética ...