Embryonal carcinoma overview

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Differentiating Embryonal carcinoma from other Diseases

Natural History, Complications and Prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Embryonal carcinoma is a type of testicular cancer of germ cell origin. It comprises about twenty-five percent of nonseminoma tumors of germ cell testicular tumors. Pure embryonal carcinomas are rare, but are very common in mixed germ cell tumors.

Historical Perspective

There's no specific information available yet on the discovery of embryonal carcinomas. However, the discovery of human chorionic gonadotropin (hcg) and α-fetoprotein (AFP) in 1927 and 1956, respectively, led to a major leap forward in the ability to diagnose, stage, and manage testicular cancer.

Classification

Embryonal carcinomas may be classified based on whether it is in a pure form or a mixed form ( i.e. component of a mixed germ cell tumor); or based on their histological patterns, which includes solid, tubular or glandlike, and papillary.

Pathophysiology

An initiating event that causes fetal gonocytes to undergo abnormal cell division is the most widely accepted theory on the development of germ cell tumors. It is also universally acknowledged that Intratubular germ cell neoplasia of unclassified type (IGCNU) is the precursor lesion of classical seminoma and non-seminomatous germ cell tumours.

Causes

The role of specific factors in the causality of embryonal carcinomais unclear.

Risk factors

Cryptorchidism, existing contralateral testicular cancer, family history of testicular cancer, genetic and environmental factors all increase the risk of developing germ cell tumors.

Epidemiology and Demographics

The incidence of embryonal carcinoma varies among different age groups. The highest incidence occurs in persons aged 20-30 years. It is extremely rare in infants. Overall, it is one of the most common germ cell tumors.

Differentiating Embryonal carcinoma from other Diseases

Embryonal carcinomas must be differentiated from other painless testicular nodules or swellings that cause scrotal discomfort, and also pathologically from other subtypes and variants of testicular cancer, including seminomas, non-seminoma germ cell tumours, non-germ cell tumors of the testis like Leydig cell tumor and Sertoli cell tumor, and secondary testicular tumors like lymphomas.

Natural History, Complications and Prognosis

Embryonal carcinoma is an aggressive tumor with high malignant potential and early metastases

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