Final Diagnosis -- Malignant Teratoma with Yolk Sac Tumor (Left Paravertebral Mass)


Unexpected Death of a 20 Month Old Boy with Malignant Teratoma
Left Paravertebral Malignant Teratoma with Yolk Sac Tumor
Collapsed T11 Vertebral Body with Tumor
Tumor in T10 and T12 Vertebral Bodies
Status Post T9-L1 Osteoplastic Laminotomy, Decompression of Spinal Canal and Biopsy of Epidural Tumor
Status Post Placement of Broviac Catheter
Tip of Catheter in Right Atrium at Autopsy
Status Post Chemotherapy:
Status Post Hyperalimentation
Myelomalacia, Subacute, T8-L1 with Hemorrhage in Adjacent Soft Tissues
Hypoplasia of Bone Marrow, Marked
Melanotic Gastrointestinal Fluid, 420 ml
Postmortem Vitreous Fluid Sodium, right 164 meq/L, left 167 meq/L
Aspiration of Gastric Contents, Agonal, Mild


This 20 month old boy underwent T9-L1 laminotomy, decompression of spinal cord, and biopsy of epidural yolk sac tumor. He was discharged on October 27 following a course of chemotherapy. He died 2 days later unexpectedly.

The autopsy revealed a paravertebral tumor with extension to the vertebral bodies. No epidural tumor was present. The tumor was largely composed of yolk sac tumor with a minor component of teratomatous elements.

The cause of unexpected death is not completely clear. However, hypernatremia was an important factor contributing to death.

Contributed by Paul S. Dickman, M.D., Yoshie Hashida, M.D., Ronald Jaffe, M.B., B.Ch., Lance Cohen, M.D., and Charles A. Richert, M.D.

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