Embryonal carcinoma is an aggressive non-seminomatous germ cell tumor characterized by primitive epithelial cells with marked variability in size and shape. It commonly presents in young men ages 20-30 years and often spreads to the retroperitoneum, lungs, or liver even without symptoms. Microscopically, the tumor cells form alveolar, tubular or papillary patterns and stain positively for OCT 3/4, PLAP, cytokeratin and CD30, but negatively for c-KIT and EMA. Embryonal carcinoma is the second most common testicular germ cell tumor, making up around 20% of cases.

1. EMBRYONA
CARCINOM

2. ETIOLOGY
•Embryonal carcinoma is a NON-SEMINOMATOUS
germ cell tumour characterized by primitive epithelial
cells with marked pleomorphism and various histologic
patterns. It may present in pure form but often is part
of a mixed germ cell tumour.
The most accepted theory on the development of germ
cell tumours involves an initiating event that causes
foetal gonocytes to undergo abnormal cell division.
DEFINITION

3. More aggressive than seminomas .
AGE GROUP : 20 -30 yrs.
2nd most common germ cell tumour -20% cases.
More than 2/3rd of patients metastases – only 10% shows symptoms.
the more common sites of metastasis are the retroperitoneum, lung,
and liver.

4. MORPHOLOGY
•GROSS
•SIZE: Smaller than seminoma & do not replace entire testis

5. External surface:
smooth &
glistening
Cut surface:
1) has a
variegated
appearance

6. 2)Poorly
demarcated
margins
3)Areas of
haemorrhage/necrosis
common

7. 4) Tumour extends
into tunica albuginea ,
epididymis or
spermatic cord

8. MICROSCOPY
•Pattern – the tumour cells are arranged in ALVEOLAR / TUBULAR /
PAPILLARY patterns .
TUBULAR PAPPILLARY

9. They lack well formed glands with basally
situated nuclei and atypical cytoplasm.

10. More undifferentiated tumour shows
sheet/cluster of cells

11. Cells having epithelial appearance are large &
anaplastic.

12. Cell borders are usually indistinct.

13. Considerable variation in cell & nuclear size and
shape .

14. Nuclei are hyperchromatic with prominent
nucleoli .

15. Mitotic figures and tumour cells are frequent.

16. IMMUNOHISTOCHEMISTRY
Positive for : OCT ¾ & PLAP( placental alkaline phosphatase)
Positive for : cytokeratin & CD30
Negative for c-KIT(CD 117) & EMA
There is also increase in alpha fetoprotein & Lactic acid
dehydrogenase .
CD 30
OCT 3/4