Neurosurgery notes/Tumours/Germ cell tumours/Embryonal carcinoma

Embryonal carcinoma

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Germ cell tumours

Definition

  • An aggressive non-germinomatous malignant germ cell tumour characterised by large epithelioid cells resembling those of the embryonic germ disc.

Frequency

  • 3.3%

Pathophysiology

  • Migrate back into the embryo from yolk sac

Histopathology

  • Macroscopic
    • Solid lesion
    • Friable greyish white tissue that may exhibit focal haemorrhage and necrosis
  • Microscopic
      • Immature-looking stem cells that resemble embryonic stem cells.
        • Embryonic stem cell arise from blastocyst
      • Large cells
      • Cells tend to grow in sheets, gland-like patterns, or as papillary structures.
      • Form absorptive papillae or line gland like spaces
      • Form embryoid bodies replete with germ disc and miniature amniotic cavities
      • Macronucleoli, abundant clear to violet hued cytoplasm
      • High mitotic count
      • Zones of coagulative necrosis
      Embryonal carcinoma composed of large epithelial cells forming abortive papillae and glandular structures with macronuclei.
      Embryonal carcinoma composed of large epithelial cells forming abortive papillae and glandular structures with macronuclei.

Immunophenotype

  • +
    • Consistent
      • CD30 (cytoplasmic) (shared with teratomas)
      • OCT4 (nuclear)
      • PLAP
      • LIN28A
      • Cytokeratins
      • ESRG (nuclear)
      • UTF1 (nuclear)
      • SALL4 (nuclear)
      • SOX2 (nuclear)
    • Inconsistent
      • KIT (focal and non-membranous)
  • -
    • Beta-hCG
    • Human placental lactogen