Testicular embryonal cell carcinoma is a type of non-seminomatous germ cell tumour and is the second most common histological type of testicular tumour after seminoma 3.
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Epidemiology
Incidence peaks at around 25-30 years.
Pathology
It may occur as part of a mixed germ cell tumour (more common and may be present as a component in around 80% of mixed germ cell tumours) 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 behaviour 3. Aggressive features (extratesticular extension and metastases) are common and associated with poor prognosis 4.
Testicular embryonal cell tumours usually show increased alpha-fetoprotein (AFP) and β-hCG levels; however, these tumour markers are mildly elevated in the pure embryonal cell tumours. These tumour marker levels reflect the tumour burden and their elevation is associated with poor outcome 5.
Radiographic features
Ultrasound
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, haemorrhage and calcifications 3,4
MRI
heterogeneous signal intensity lesion with areas of haemorrhage and necrosis 4
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