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Embryonal Carcinoma : Differential Diagnosis

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Differential Diagnosis: Ovarian embryonal carcinoma (EC) needs to be distinguished from other ovarian germ cell tumors. Various entities in the differential (and the features favoring them) are listed below:

Dysgerminoma: Solid areas of EC (as shown in the image above) can resemble dysgerminoma. Features favoring dysgerminoma - less pleomorphism, fibrous septa with lymphoplasmacytic infiltrate, distinct cell borders, negative for CD30, dot-like or membrane staining for cytokeratin in 30% of cases, positive for CD117.

Yolk Sac Tumor: less pleomorphic than EC, negative for CD30 and OCT4, strong positivity for AFP and glypican-3.

High-grade Ovarian Carcinomas (high-grade serous carcinoma, undifferentiated carcinoma, and carcinosarcoma): mostly seen in adults and rarely in children, positive for EMA and negative for SALL4 and OCT4.

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