• Tariq Mufti
  • M. Saeed Khan
  • Muzher -U- Dua
  • Farah Waqar


We report a 2 ½ years old female child who presented with Malignant Sacrococcygeal Yolk sac (Endodermal Sinus) tumor as presacral mass with ulceration of overlying skin. Her ultrasonography (USG)abdomen revealed  a huge presecral mass with irregular margins extending in to the pelvis, pushing the rectum antero-laterally. CT scanning of abdomen confirmed USG finding with out enlargement of retroperitoneal lymph nodes and no involvement of the liver. Serum AFP was abnormally elevated. The tumor was excised along with Coccyx in-toto through posterior approach dividing the sacrum and 3-Drugs (VAC) Chemotherapy started post–operatively i.e. 2-weeks after surgery. Here we discuss our experience with this extremely rare malignant extra-gonadal germ-cell tumor and review of literature.‘We can say with some assurance that although children may be victims of fate, they will not be the victims of our neglect (John F Kennedy)(1)’


Straus MB. Familiar Medical quotations. Boston, Little Brown and Co. 1968.

Philip A, Pizzodevaid G, Poplack , Daniel, Harris and Larry Ed: In Germs cell tumors. Devita principle and practice of Oncology (4th ed ) JB Lippincott. Co. 1976

Reaman GH, Cohan LF: Less frequently encountered malignant neoplasms. In Levine AS (ed) cancer. Young. New-Yark Masson publ. 1982; pp 707-727.

Young JL, Miller RW. Incidence of malignant tumors in US children. J Pediatr 1975;86:254-258.

Altman RP, Reudolph JG, Lilly OR. Sacro coccygeal teratoma American academy of Paediatric. Surgical section survey. J Pediatr Surg 1974;9:389-398.

Grosfield JL, Ballantine TVN, Lowed AU. Benign and malignant teratomas in children. Analysis of 85 patients. Surg 1975;80: 297-305.

Donnellan WA, Swenson O. Benign and malignant sacro-coccygeal teratomas. Surg 1968;64: 834-846.

Tsuchiday, Urano Y, Eudo Y. A study of AFP in endodermal sinus tumor. J Pediatr Surg 1975;10: 501-506.

Albin AJ. Malignant germs cell tumors in children. Watth JM (ed) Childhood cancer frontier of Radiation and Oncology Vol. 16. Basel.S Karger 1981 pp 141-149.

Ein SH, Mancer K, Adeyemi SD. Malignant sacro coccygeal teratoma, endodermal sinus (yolk sac) tumors in infants in children. J Pediatr Surg 1985; 20: 473-477.

Albin AJ, Ramsay N, Krailo M, Atkin J, Isaacs H. Effective therapy of malignant gems cell tumors in children. A study by the children’s cancer study group-1985 Asco. Abstracts :C-419.

Cushing BA, Phillipart AI, Brough AJ, Dass I. Eextra- gonadol endodermal sinus tumors in early childhood. Treatment responses and long term effects. Proceed. Asco 1985; 4: 242.

Etcubanas E, Thompson E, Rao B, Hastu. Treatment of childhood germs cell tumors (GCT). Results of prospective study. Proceed Asco 1981;4: 238.

Faun IG, Sampson NK, Stephen SR. PVB therapy in disseminated extra-gonadol germs cell tumors. A SWOG study. Cancer 1980;45: 2543-2549.

Flament F, Sechwartz I, Delons E, Cailliaud JM. Non-Seminomatous germs cell tumors in children. Multi drug therapy in stage-III-IV. Cancer 1984;54:1687-1691.

Grosfield JL, Billimire DF (1985): teratomas in infancy and childhood. Current problems in cancer. 1985; 9: 1-53.

Logothetis CJ, Samoel ML, Selig DE. Chemotherapy extra-gonadol germs cell tumors. J Clin Oncol 1981;3:316-325.

Thomas WJ, Dewal AB. Successful treatment of metastatic extra-gonadol yolk sac tumors in childhood. Cancer1981;48: 2371-2374.

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