Case Report
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World J Gastroenterol. Feb 7, 2010; 16(5): 652-656
Published online Feb 7, 2010. doi: 10.3748/wjg.v16.i5.652
Primary mixed germ cell tumor of the liver with sarcomatous components
Ai-Min Xu, Shao-Juan Gong, Wei-Hua Song, Xiao-Wei Li, Chun-Hua Pan, Jun-Jun Zhu, Meng-Chao Wu
Ai-Min Xu, Shao-Juan Gong, Wei-Hua Song, Xiao-Wei Li, Chun-Hua Pan, Jun-Jun Zhu, Meng-Chao Wu, Third Department of Intervention Radiotherapy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
Author contributions: Xu AM and Wu MC designed the research and wrote the manuscript; Gong SJ, Song WH and Li XW performed the research; Pan CH and Zhu JJ analyzed the data.
Correspondence to: Ai-Min Xu, MD, Third Department of Intervention Radiotherapy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Road, Shanghai 200438, China. xuarmy@163.com
Telephone: +86-21-81875181 Fax: +86-21-81875181
Received: December 1, 2009
Revised: December 24, 2009
Accepted: December 31, 2009
Published online: February 7, 2010
Abstract

Germ cell tumor (GCT) of the liver is extremely rare. Here, we describe a case of hepatic mixed GCT with significant sarcomatous components and elevated serum α-fetoprotein (AFP) in a 34-year-old man. Histopathologically, the tumor was composed of two GCTs components: yolk sac tumor and immature teratoma. The predominant components of immature teratoma consisted of several types of tissue that represented different germinal layers (endoderm, mesoderm and ectoderm) and showed varying degrees of differentiation with significant sarcomatous components. The yolk sac component showed positivity for AFP and cytokeratin (AE1/AE3). The immature teratoma components showed positivity for varying differentiation markers. Interphase cytogenetic analysis revealed that the yolk sac tumor and immature teratoma were positive for i(12p) and 12p over-representation. In particular, the rhabdomyoblastic components also showed typical i(12p) and 12p overrepresentation. This suggested that sarcomatous components may be associated with dedifferentiation or malignant transformation of certain mesenchymal components within teratoma.

Keywords: Germ cell tumor; Teratoma; Sarcoma; Liver neoplasms