Pineal embryonal carcinoma

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Synonyms and Keywords: Pineal embryonal cell carcinoma; Pineal gland tumor; Brain tumor


  • Pineal embryonal carcinoma is a relatively rare malignant neoplasm and accounts for a small proportion of all intracranial germ cell tumors. It is an aggressive tumor and has a propensity to metastasise systemically. A component of embryonal carcinoma is often found in mixed germ-cell tumours, in which case it is usually the most aggressive component, and dictates prognosis. Pure pineal embryonal carcinoma tumors do not secrete β-HCG or AFP.[1]
  • On microscopic histopathological analysis, pineal embryonal carcinoma is characterized by:[2]
    • Poorly differentiated, pleomorphic cells in cords, sheets, or papillary formation
    • Indistinct cell borders
    • Nucleoli - key feature
    • Vesicular nuclei (clear, empty appearing nuclei) - key feature
    • Necrosis - common
    • Mitoses - common
    • Variable architecture:
      • Solid (predominant in ~55% of cases)
      • Glandular (predominant in ~17% of cases)
      • Papillary (predominant in ~11% of cases)
      • Nested
      • Micropapillary
      • Anastomosing glandular
      • Sieve-like glandular
      • Pseudopapillary
      • Blastocyst-like
      • Embryoid bodies - ball of cells in surrounded by empty space on three sides
  • Pineal embryonal carcinoma is demonstrated by positivity to tumor markers such as:[3]
  • Pineal embryonal carcinoma must be differentiated from:
  • Common complications of pineal embryonal carcinoma include:


  1. Intracranial embryonal carcinoma. Frank Gaillard et al. Radiopaedia 2015. Accessed on December 4, 2015
  2. Microscopic features of embryonal carcinoma. Libre Pathology 2015. Accessed on December 4, 2015
  3. IHC features of embryonal carcinoma. Libre Pathology 2015. Accessed on December 4, 2015