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# Nonseminomatous germ cell tumours

- Lesion

These tumours copy embryonic tissues; most are mixtures, and each component carries its own marker and behaviour.

Updated Nov 12, 2026

## Key points

- Embryonal carcinoma: hemorrhagic, necrotic mass; sheets and glands of anaplastic cells; CD30 and OCT3/4 positive.
- Yolk sac tumour: reticular pattern, Schiller-Duval bodies (glomerulus-like), hyaline globules; AFP high.
- Choriocarcinoma: syncytiotrophoblast and cytotrophoblast with hemorrhage; very high hCG; may cause gynecomastia or hyperthyroidism.
- Postpubertal teratoma: mature or immature tissues, malignant behaviour; can grow somatic cancers (sarcoma, carcinoma).
- Prepubertal teratoma and yolk sac tumour: not linked to GCNIS or 12p.

## What it is

Nonseminomatous germ cell tumours mimic stages of embryonic development. Embryonal carcinoma is made of primitive, pleomorphic cells and is aggressive. Yolk sac tumour reproduces yolk sac and makes AFP; in its prepubertal form it is the commonest testicular tumour of infants and young children. Choriocarcinoma copies placenta, makes hCG and spreads early by blood. Teratoma contains tissues from more than one germ layer; prepubertal teratoma is benign, while postpubertal teratoma is malignant whatever its maturity. Most nonseminomatous tumours are mixed, often with seminoma.

## Structure

- Embryonal carcinoma: grey-white mass with hemorrhage and necrosis; large primitive cells in solid, glandular or papillary arrays.
- Yolk sac: lacy network of cuboidal cells; papillae with central vessel in a space (Schiller-Duval body).
- Choriocarcinoma: small hemorrhagic tumour, sometimes with large metastases; two cell types with no villi.
- Teratoma: cysts and solid areas with cartilage, squamous epithelium, glands, neural tissue.

## Clinical notes

- Metastases may be larger than the testicular primary, especially in choriocarcinoma.
- Residual teratoma after chemotherapy is removed surgically because it can grow.

## Memory aid

Embryo, yolk, placenta and the three germ layers: the tumour replays the first weeks of life.

## Test yourself

Think of the answer, then tap the question to see it.

## What is a Schiller-Duval body?

A glomerulus-like structure with a central vessel surrounded by tumour cells in a space, typical of yolk sac tumour.

## Which germ cell tumour produces the highest hCG levels?

Choriocarcinoma.

## How does the behaviour of teratoma differ before and after puberty?

Prepubertal teratoma is benign; postpubertal teratoma is regarded as malignant even when its tissues look mature.

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## Elsewhere in DurgiPedia

- [Alpha-fetoprotein (AFP)](https://durgical.com/en/biochemistry/topics/alpha-fetoprotein/)
- [Tumours of infancy and childhood](https://durgical.com/en/general-pathology/tumours-of-infancy-and-childhood/)
- [Tumour markers: serum and tissue, and what each one is for](https://durgical.com/en/general-pathology/tumour-markers-serum-and-tissue-and-what-each-one-is-for/)

## Connections

## Related 4

- [Testicular germ cell tumours: overview](https://durgical.com/en/general-pathology/testicular-germ-cell-tumours-overview/)
- [Seminoma and spermatocytic tumour](https://durgical.com/en/general-pathology/seminoma-and-spermatocytic-tumour/)
- [Tumours of infancy and childhood](https://durgical.com/en/general-pathology/tumours-of-infancy-and-childhood/)
- [Tumour markers: serum and tissue, and what each one is for](https://durgical.com/en/general-pathology/tumour-markers-serum-and-tissue-and-what-each-one-is-for/)

## Related conditions 3

- [Testicular cancer](https://durgical.com/en/conditions/testicular-cancer/)
- [Gynaecomastia](https://durgical.com/en/conditions/gynaecomastia/)
- [Molar pregnancy (hydatidiform mole)](https://durgical.com/en/conditions/molar-pregnancy/)

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Testicular Cancer](https://www.ncbi.nlm.nih.gov/books/NBK563159/) (StatPearls (NCBI Bookshelf), 2024); [Testicular Cancer Treatment](https://www.cancer.gov/types/testicular/patient/testicular-treatment-pdq) (National Cancer Institute, 2025).

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Representative model, for educational purposes only.

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