Intracranial embryonal carcinoma: a clinicopathologic study of ten cases and review of the literature

Objective: Embryonal carcinoma (EC) is an uncommon subtype of intracranial germ cell tumors. The aim of this study is to determine the clinical characteristics and prognosis of EC. Methods: A total of ten EC patients were underwent surgical treatment. Three patients gained total resection (TR) and seven gained subtotal resection (STR). Radiotherapy was provided in nine patients and chemotherapy was provided in eight patients. Their clinical data, radiological, histopathological features and postoperative follow-up were analyzed retrospectively. Results: All ten patients had follow-up with a median follow-up period of 23.5 months. The pineal gland was the most common site (n=6) and headache was the most common symptom (n=6). Highly elevated alpha fetoprotein (AFP) and beta subunit human chorionic gonadotropin (β-HCG) were recorded in seven and one patient, respectively. The tumor cells have a relatively high MIB-1 labeling index ranging from 40% to 90% by immunohistochemical staining. The median overall survival (OS) time for EC with TR compared to STR was 35 months to 20 months (P=0.028). The median OS time for patients with normal AFP compared to elevated AFP was 28 months to 20 months (P=0.49). Conclusions: EC is a rare subtype of intracranial germ cell tumors with a tendency to present in younger patients and has a male bias. EC has a poor prognosis. The extent of resection is an important prognosis factor. More data should be collected in order to evaluate the role of the AFP in diagnosing the EC and predicting the prognosis.