{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:10:03Z","timestamp":1756375803920,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,9,9]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>Paediatric germ cell tumours (GCT) are rare tumours and are unique because of varied clinical presentation and locations. Yolk sac tumour is the predominant malignant histology and a serum marker; alpha fetoprotein is used to see treatment response and recurrent disease. It is extremely rare to find a retroperitoneal GCT with tumour thrombus extending up to the cavo-atrial region with involvement of the hepatic veins. We report a case of retroperitoneal yolk sac tumour (RPYST) with extension to the liver and right adrenal gland along with tumour thrombus in the inferior vena cava and in the right and middle hepatic veins. The child was operated after satisfactory response to chemotherapy. Excision of the tumour along with the right adrenal gland and around 5\u2009cm of retro-hepatic caval resection was done. Inferior vena cava resection was tolerated without reconstruction. Currently child is disease-free and symptom-free at 22 months of follow-up with normal serum marker.<\/jats:p>","DOI":"10.1136\/bcr-2023-255968","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T11:45:40Z","timestamp":1699011940000},"page":"e255968","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Retroperitoneal yolk sac tumour encroaching the liver and adrenal gland with tumour thrombus in cavo-atrial region and hepatic veins"],"prefix":"10.1136","volume":"16","author":[{"given":"Pujana","family":"Kanneganti","sequence":"first","affiliation":[{"name":"Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0401-028X","authenticated-orcid":false,"given":"Anju","family":"Verma","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basant","family":"Kumar","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Nigam","sequence":"additional","affiliation":[{"name":"Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"key":"2025082802460762000_16.11.e255968.1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008360523160"},{"key":"2025082802460762000_16.11.e255968.2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4103\/0971-9261.91079","article-title":"Atypical extragonadal germ cell tumours","volume":"17","author":"Deb","year":"2012","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"2025082802460762000_16.11.e255968.3","doi-asserted-by":"crossref","first-page":"528","DOI":"10.14701\/ahbps.2021.25.4.528","article-title":"Extensive cavo-atrial and hepatic venous tumor thrombus in a mismanaged retroperitoneal pediatric germ cell tumor: a unique surgical challenge","volume":"25","author":"Kazi","year":"2021","journal-title":"Ann Hepatobiliary Pancreat Surg"},{"key":"2025082802460762000_16.11.e255968.4","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.2214\/ajr.145.6.1165","article-title":"Unusual thoracoabdominal sites of metastases in testicular tumors","volume":"145","author":"Husband","year":"1985","journal-title":"AJR Am J Roentgenol"},{"key":"2025082802460762000_16.11.e255968.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(99)80366-5"},{"key":"2025082802460762000_16.11.e255968.6","first-page":"371","article-title":"Tumor thrombus arising from the superior vena cava and extending into the right atrium in a patient with advanced testicular germ cell tumor","volume":"55","author":"Miyake","year":"2009","journal-title":"Hinyokika Kiyo"},{"key":"2025082802460762000_16.11.e255968.7","article-title":"Radical resection of a late-relapsed testicular germ cell tumour: hepatectomy, cavotomy, and thrombectomy","volume":"2014","author":"N\u00ed Leidhin","year":"2014","journal-title":"Case Rep Surg"},{"key":"2025082802460762000_16.11.e255968.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.06.041"},{"key":"2025082802460762000_16.11.e255968.9","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2021.753232","article-title":"Management of pediatric tumors with vascular extension","volume":"9","author":"Fanelli","year":"2021","journal-title":"Front Pediatr"},{"key":"2025082802460762000_16.11.e255968.10","doi-asserted-by":"crossref","unstructured":"Sudour-Bonnange H , Faure-Conter C , Martelli H , et al . Primary mediastinal and retroperitoneal malignant germ cell tumors in children and adolescents: results of the TGM95 trial, a study of the French society of pediatric oncology (Soci\u00e9t\u00e9 Fran\u00e7aise des cancers de L'Enfant). Pediatr Blood Cancer 2017;64. doi:10.1002\/pbc.26494","DOI":"10.1002\/pbc.26494"},{"key":"2025082802460762000_16.11.e255968.11","first-page":"265","article-title":"Operative considerations in pediatric retroperitoneal teratomas-a review","volume":"23","author":"Jones","year":"2013","journal-title":"Eur J Pediatr Surg"},{"key":"2025082802460762000_16.11.e255968.12","doi-asserted-by":"crossref","first-page":"7638","DOI":"10.1007\/s00464-022-09232-8","article-title":"Biochemical assessment of adrenal insufficiency after adrenalectomy for non-cortisol secreting tumors: clinical correlation and recommendations","volume":"36","author":"Kahramangil","year":"2022","journal-title":"Surg Endosc"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-255968","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:46:14Z","timestamp":1756374374000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-255968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":12,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,3]]},"published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1136\/bcr-2023-255968"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-255968","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}