An infant with a pancreatic yolk sac tumour presenting with obstructive jaundice – A case report

Yolk sac tumours (YST) are malignant germ cell tumours that might have gonadal or extragonadal location. Extra-gonadal germ cell tumours often show an axial distribution, such as brain, neck, mediastinum, vagina, and sacrococcygeal region. YST in the pancreas are extremely rare. Herein, we aim to describe a rare case of pancreatic YST in a child with anatomical significance.  
Case report: An eleven-month-old girl presented with features of obstructive jaundice for a one-week duration. Examination revealed deep icterus, without palpable abdominal mass. Serum alpha-fetoprotein (AFP) was significantly increased with normal serum beta-hCG. Other investigations showed an obstructive pattern liver enzyme, and imaging showed a heterogeneously enhancing, well-defined lesion in the head and neck of the pancreas. Child underwent Whipple’s surgery and received adjuvant chemotherapy. Histology and immunohistochemistry confirmed the diagnosis of YST. The patient’s condition improved following surgery.  
This case demonstrates the importance of considering pancreatic tumours as a differential diagnosis for obstructive jaundice in children. Histology and immunohistochemistry play a significant role in arriving at a definitive diagnosis. Early diagnosis and multidisciplinary management help improve the outcome.