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Clinical Presentation: Primary embryonal carcinoma of the ovary usually occurs in adolescents and young adults (median age at presentation 12 years; age range 4-28 years; 50% of patients are premenarchal). It presents as a rapidly enlarging pelvic mass causing abdominal pain and symptoms related to a mass. The patient may also develop isosexual precocity, menstrual irregularities or virilization. About 50% of cases show elevated beta-hCG levels, sometimes even resulting in a positive pregnancy test. Serum AFP is usually normal. Some cases are associated with a gonadoblastoma.