Testicular embryonal cell carcinoma

Last revised by Arlene Campos on 31 Jan 2024

Testicular embryonal cell carcinoma is a type of non-seminomatous germ cell tumor and is the second most common histological type of testicular tumor after seminoma 3.

Incidence peaks at around 25-30 years.

It may occur as part of a mixed germ cell tumor (more common and may be present as a component in around 80% of mixed germ cell tumors) or very rarely in pure form (2-3%) 3. It has components of primitive anaplastic-appearing epithelial cells. At the time of presentation, it is usually smaller than the seminoma but has more aggressive behavior 3. Aggressive features (extratesticular extension and metastases) are common and associated with poor prognosis 4.

Testicular embryonal cell tumors usually show increased alpha-fetoprotein (AFP) and β-hCG levels; however, these tumor markers are mildly elevated in the pure embryonal cell tumors. These tumor marker levels reflect the tumor burden and their elevation is associated with poor outcome 5.

  • hypoechoic heterogeneous mass lesion with ill-defined outlines and involvement of the tunica albuginea and abnormal outline of the testis 3,4

  • Ill-defined areas of necrosis, hemorrhage and calcifications 3,4

  • heterogeneous signal intensity lesion with areas of hemorrhage and necrosis 4

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