Manifestations and therapeutic considerations in pineal yolk-sac tumors. Case report.

A 20-month-old patient with a paraventricular and parapineal yolk-sac tumor was treated with subtotal excision and total neuraxis irradiation. She has done well in the 3 1/2 years since surgery. A comparative review of similar pineal and gonadal yolk-sac tumors suggests role for surgery combined with radiotherapy and chemotherapy. Additional experience with these unusual germ-cell neoplasms should establish the need for aggressive extirpation, not only to determine the exact diagnosis, but also to provide the basis for subsequent adjunctive therapy. The latter may include specific combination of antineoplastic drugs in addition to radiation.