{"entity":{"id":"embryonal-carcinoma-testis","kind":"cancer","name":"Embryonal carcinoma of the testis","aka":["Embryonal carcinoma","Testicular embryonal carcinoma","Pure embryonal carcinoma","Embryonal carcinoma-predominant mixed germ cell tumour"],"tldr":"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.\n\nHow 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.\n\nHow common: no separate incidence figure; it is present in most non-seminomas (Am J Surg Pathol 2004).\n\nTreatment: 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).","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Embryonal_carcinoma","links":[{"label":"NCI PDQ: testicular cancer treatment","url":"https://www.cancer.gov/types/testicular/treatment"},{"label":"Moch 2016, European Urology: the 2016 WHO classification of urinary and male genital tumours, part A","url":"https://doi.org/10.1016/j.eururo.2016.02.029"},{"label":"Am J Surg Pathol 2004: OCT4 staining in testicular tumours, a marker for seminoma and embryonal carcinoma","url":"https://doi.org/10.1097/00000478-200407000-00014"}],"tags":["subtype-page","wave4","testicular","rare"],"related":["non-seminoma","testicular","yolk-sac-tumour-postpubertal","testicular-choriocarcinoma","germ-cell-neoplasia-in-situ","seminoma"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":["bleomycin","etoposide","cisplatin"],"companies":[],"institutions":[],"pathways":[],"terms":["afp","tumour-markers"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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"],"standardOfCare":[{"setting":"All stages","approach":"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.","refs":["non-seminoma","testicular","bleomycin","etoposide","cisplatin"]}],"stateOfArt":[],"history":[],"pipeline":[],"openProblems":[],"parent":"non-seminoma"},"route":"/cancers/embryonal-carcinoma-testis/","neighbours":{"cancer":[{"id":"testicular-choriocarcinoma","kind":"cancer","name":"Choriocarcinoma of the testis","route":"/cancers/testicular-choriocarcinoma/"},{"id":"germ-cell-neoplasia-in-situ","kind":"cancer","name":"Germ cell neoplasia in situ (GCNIS)","route":"/cancers/germ-cell-neoplasia-in-situ/"},{"id":"non-seminoma","kind":"cancer","name":"Non-seminomatous germ cell tumour","route":"/cancers/non-seminoma/"},{"id":"seminoma","kind":"cancer","name":"Seminoma","route":"/cancers/seminoma/"},{"id":"testicular","kind":"cancer","name":"Testicular germ cell tumours","route":"/cancers/testicular/"},{"id":"yolk-sac-tumour-postpubertal","kind":"cancer","name":"Yolk sac tumour of the testis, postpubertal type","route":"/cancers/yolk-sac-tumour-postpubertal/"}],"drug":[{"id":"bleomycin","kind":"drug","name":"Bleomycin","route":"/drugs/bleomycin/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"etoposide","kind":"drug","name":"Etoposide","route":"/drugs/etoposide/"}],"term":[{"id":"afp","kind":"term","name":"Alpha-fetoprotein (AFP)","route":"/terms/afp/"},{"id":"tumour-markers","kind":"term","name":"Tumour markers (CEA, LDH, chromogranin, thyroglobulin)","route":"/terms/tumour-markers/"}]}}