# Embryonal carcinoma of the testis

Source: https://onco.cc/cancers/embryonal-carcinoma-testis/  
OnCo record `embryonal-carcinoma-testis` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Embryonal carcinoma is the most aggressive and most common building block of non-seminoma testicular cancer, made of primitive cells that resemble an early embryo and can turn into the other tumour types. On its own or as the main component it spreads early to lymph nodes and lungs, but it is highly sensitive to cisplatin chemotherapy and most men are cured.

## Summary

Embryonal carcinoma is a germ cell tumour of totipotent cells growing in solid, papillary and glandular patterns with marked atypia, arising from germ cell neoplasia in situ and forming part of most mixed non-seminomatous tumours (Moch 2016). OCT4 (POU5F1), the pluripotency transcription factor, stains embryonal carcinoma and seminoma in every case among 91 testicular neoplasms tested and no other tumour type, and CD30 and SOX2 separate embryonal carcinoma from seminoma (Am J Surg Pathol 2004). Its share of a mixed tumour and the presence of lymphovascular invasion are the two histological risk factors used to decide adjuvant treatment of stage I non-seminoma.

How it differs from its parent: the non-seminoma page covers the group; embryonal carcinoma is its most proliferative component, does not raise alpha-fetoprotein on its own (a raised value implies yolk sac elements) and raises beta-hCG only modestly, and its predominance marks a higher relapse risk after orchidectomy.

How common: no separate incidence figure; it is present in most non-seminomas (Am J Surg Pathol 2004).

Treatment: as non-seminoma by stage and International Germ Cell Cancer Collaborative Group risk group: orchidectomy, then surveillance or one cycle of BEP for stage I depending on lymphovascular invasion and embryonal carcinoma predominance, and three or four cycles of BEP for metastatic disease with resection of residual masses (NCI PDQ testicular summary and the parent page).

## Fields

- Kind: Cancer
- Last checked: 2026-09-24
- Also known as: Embryonal carcinoma; Testicular embryonal carcinoma; Pure embryonal carcinoma; Embryonal carcinoma-predominant mixed germ cell tumour
- Tags: subtype-page; wave4; testicular; rare
- Group: genitourinary
- Burden: The commonest component of non-seminomatous germ cell tumours: 54 of 64 mixed germ cell tumours in a marker study contained embryonal carcinoma, more than seminoma (51), yolk sac tumour (38) or teratoma (Am J Surg Pathol 2004). Pure embryonal carcinoma is a minority of testicular cancers; no registry figure was found in the sources read.
- Subtypes: Pure embryonal carcinoma; Mixed germ cell tumour with embryonal carcinoma predominance (over 50 percent; higher relapse risk in stage I); Embryonal carcinoma with lymphovascular invasion (risk factor for adjuvant therapy); Intratubular embryonal carcinoma (GCNIS-related precursor stage)
- Biomarkers: OCT4, CD30 and SOX2 positive; Beta-hCG (modestly raised); alpha-fetoprotein normal unless yolk sac elements; Lymphovascular invasion and embryonal carcinoma percentage (stage I risk factors); Isochromosome 12p

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/embryonal-carcinoma-testis/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/embryonal-carcinoma-testis/#overview
- What it is (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/embryonal-carcinoma-testis/#what-it-is [4 subtypes]
- Finding it (on the hub): How it shows itself, how it is confirmed, what screening exists, and the biomarkers clinicians test for. https://onco.cc/cancers/embryonal-carcinoma-testis/#finding-it [4 biomarkers]
- Treating it (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/embryonal-carcinoma-testis/#treating-it [1 setting, 1 decision with options]
- Evidence (on the hub): Trials recruiting now, the landmark trials, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/embryonal-carcinoma-testis/#evidence
- The science (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/embryonal-carcinoma-testis/#science [1 target]
- Where you are (own page): Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record. https://onco.cc/cancers/embryonal-carcinoma-testis/where-you-are/
- Living with it (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/embryonal-carcinoma-testis/#living-with-it [8 questions, 6 red cards]
- What is coming (own page): Everything in development, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/embryonal-carcinoma-testis/coming/ [3 medicines]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/embryonal-carcinoma-testis/data/ [12 connected records]

## Standard of care

- All stages: Treated as non-seminoma by stage and risk group: orchidectomy, surveillance or one cycle of BEP for stage I by risk factors, three or four cycles of BEP for metastatic disease with resection of residual masses. ([Non-seminomatous germ cell tumour](https://onco.cc/cancers/non-seminoma/), [Testicular germ cell tumours](https://onco.cc/cancers/testicular/), [Bleomycin](https://onco.cc/drugs/bleomycin/), [Etoposide](https://onco.cc/drugs/etoposide/), [Cisplatin](https://onco.cc/drugs/cisplatin/))

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Embryonal_carcinoma
- NCI PDQ: testicular cancer treatment: https://www.cancer.gov/types/testicular/treatment
- Moch 2016, European Urology: the 2016 WHO classification of urinary and male genital tumours, part A: https://doi.org/10.1016/j.eururo.2016.02.029
- Am J Surg Pathol 2004: OCT4 staining in testicular tumours, a marker for seminoma and embryonal carcinoma: https://doi.org/10.1097/00000478-200407000-00014

## Connected records

- cancers: [Choriocarcinoma of the testis](https://onco.cc/cancers/testicular-choriocarcinoma/), [Germ cell neoplasia in situ (GCNIS)](https://onco.cc/cancers/germ-cell-neoplasia-in-situ/), [Non-seminomatous germ cell tumour](https://onco.cc/cancers/non-seminoma/), [Seminoma](https://onco.cc/cancers/seminoma/), [Testicular germ cell tumours](https://onco.cc/cancers/testicular/), [Yolk sac tumour of the testis, postpubertal type](https://onco.cc/cancers/yolk-sac-tumour-postpubertal/)
- drugs: [Bleomycin](https://onco.cc/drugs/bleomycin/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [Etoposide](https://onco.cc/drugs/etoposide/)
- terms: [Alpha-fetoprotein (AFP)](https://onco.cc/terms/afp/), [Tumour markers (CEA, LDH, chromogranin, thyroglobulin)](https://onco.cc/terms/tumour-markers/)

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JSON: https://onco.cc/api/v1/entities/embryonal-carcinoma-testis.json