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4 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
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.
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.
| Setting | Approach | Guideline |
|---|---|---|
| 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. | not mapped |