Carcinome embryonnaire

Embryonal carcinoma is a relatively uncommon type of germ cell tumour that occurs in the ovaries and testes. The presenting features may be a palpable testicular mass or asymmetric testicular enlargement in some cases. The tumour may present as signs and symptoms relating to the presence of widespread metastases, without any palpable lump in the testis. The clinical features associated with metastasising embryonal carcinoma may include low back pain, dyspnoea, cough, haemoptysis, haematemesis and neurologic abnormalities. Males with pure embryonal carcinoma tend to have a normal amount of the protein alpha-fetoprotein in the fluid component of their blood. The finding of elevated amounts of alpha-fetoprotein is more suggestive of a mixed germ cell tumour, with the alpha-fetoprotein being released by the yolk sac tumour component. The gross examination usually shows a two to three centimetre pale grey, poorly defined tumour with associated haemorrhage and necrosis. The microscopic features include: indistinct cell borders, mitoses, a variable architecture (tubulopapillary, glandular, solid, embryoid bodies – ball of cells surrounded by empty space on three sides), nuclear overlap, and necrosis. Solid (55%), glandular (17%), and papillary (11%) are the most common primary patterns (predominant architectural pattern occupying at least 50%). Other less common primary patterns included nested (3%), micropapillary (2%), anastomosing glandular (1%), sieve-like glandular (