Pineal embryonal carcinoma

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

Synonyms and keywords:

Overview

• Pineal embryonal carcinoma is a relatively rare malignant neoplasm and accounts for a small prportion 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 usually the most aggressive component, and dictates prognosis. Pure pineal embryonal carcinoma tumors do not secrete β-HCG or AFP.
• On microscopic histopathological analysis, pineal embryonal carcinoma is characterized by:
  • 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:

References

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