CNS tumor

Embryonal tumors

Embryonal tumor with multilayered rosettes

Medulloepithelioma, C19MC not altered

Topic Completed: 1 November 2016

Minor changes: 9 September 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Medulloepithelioma CNS [title]

Nirupama Singh, M.D., Ph.D.
Page views in 2020: 1,430
Page views in 2021 to date: 1,190
Cite this page: Singh N. Medulloepithelioma, C19MC not altered. website. Accessed December 8th, 2021.
Definition / general
  • CNS embryonal tumor with (a) prominent pseudostratified neuroepithelium that resembles the embryonic neural tube and (b) poorly differentiated neuroepithelial cells
  • Aggressive CNS embryonal tumor with multilayered rosettes (ETMR), with (a) amplicon C19MC altered, (b) C19MC unaltered or (c) C19MC not tested
  • Significant proportions of medulloepithelioma have not shown C19MC alterations (Acta Neuropathol 2016;131:803)
Essential features
  • Belongs to ETMR, a new subclassification of embryonal tumors, some of which have C19MC alterations
  • C19MC altered embryonal tumors overexpress LIN28A protein
  • Poor prognosis
ICD coding
  • Equal in males and females
  • Mostly < 2 years of age
  • Supratentorial in both hemispheres (70%)
  • Infratentorial in cerebellum and brain stem (30%)
Clinical features
  • Signs and symptoms of increased intracranial pressure (headache, nausea and visual disturbances)
  • Focal neurologic signs (ataxia and weakness)
  • WHO grade IV
Radiology description
  • Contrast enhancing large tumor masses on CT and MRI
Case reports
Microscopic (histologic) description
  • Neoplastic pseudostratified neuroepithelium resembling embryonic neural tube, with papillary, tubular and trabecular arrangements
  • Sheets of poorly differentiated cells with hyperchromatic nuclei and high N/C ratio
  • Multilayered rosettes may be seen
  • Periodic acid-Schiff positive external limiting membrane
  • No cilia or blepharoplasts on luminal surface of tubules
  • Abundant mitotic figures
  • Rarely mesenchymal differentiation and melanin pigment
Positive stains
Negative stains
Molecular / cytogenetics description
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