Presacral medulloepithelioma

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neuroepithelium with an external limiting membrane. Multiple lines of differentiation including neural, glial and mesenchymal elements may be displayed.[1].
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Presacral medulloepithelioma Sir, Medulloepithelioma is a rare malignant embryonal tumor affecting young children between 6 months and 5 years of age. The most common site is periventricular within the cerebral hemispheres.[1] A 3-year-old girl presented with swelling below the coccyx of 7 months’ duration. The swelling was slowly increasing in size. She was an active afebrile child with a 4 × 5 cm swelling in the natal cleft extending onto the right gluteal region. It was cystic in consistency and non-transluminant. The spine was normal. Right inguinal lymph node measuring 2cm was palpable. No other swelling elsewhere was detected. Hematological, biochemical and serological investigations were within normal limits. Serum alpha-fetoprotein was 0.984 IU/ml (Normal -