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

Overview

  • 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:

References

  1. Intracranial embryonal carcinoma. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/intracranial-embryonal-carcinoma. Accessed on December 4, 2015
  2. Microscopic features of embryonal carcinoma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Embryonal_carcinoma. Accessed on December 4, 2015
  3. IHC features of embryonal carcinoma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Embryonal_carcinoma. Accessed on December 4, 2015

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