YOLK SAC TUMOR IN CHILDHOOD AT THE CENTRAL HOSPITAL OF THE SOCIAL SECURITY INSTITUTE: CASE REPORT

Abstract

The endodermal sinus tumor (EST), also known as yolk sac tumor, is a rare malignant germ cell neoplasm, predominantly affecting young children. Vaginal location is extremely uncommon. We report the case of a 2-year and 8-month-old girl with vaginal bleeding and a friable mass at the introitus. Biopsy confirmed extragonadal EST with typical histological pattern and positivity for tumor markers, including alpha-fetoprotein (AFP), Glypican-3, and PLAP. Magnetic resonance imaging showed a mass confined to the vagina without local invasion. After initial surgical resection, markers remained elevated, and adjuvant chemotherapy with cisplatin, etoposide, and bleomycin was indicated. AFP normalized and follow-up exams showed no signs of recurrence. This case highlights the importance of clinical suspicion in atypical vaginal bleeding during childhood, as well as the essential role of immunohistochemistry in diagnosis. Conservative management with surgery and chemotherapy allowed satisfactory response, avoiding more aggressive procedures. Favorable evolution reinforces the need for early recognition and individualized approach to preserve patient quality of life and reproductive future.