I'm of the mind of option B also.
Another game to draw some analogies from is Terraria. In Terraria when the world is generated you know there will be some form of 'corrupted' area but it may be of different variants. One of those is blue and the other is red. Depending on which variant you get different monsters and bosses are seeded for that area.
Taking this idea you can build on it as many layers of detail as fit your world. Similar to +Meatsack's example lets say you devise 4 'end game' scenarios a world might have when generated; but only one possible per world.
- Skeletal invasion
- Demonic invasion
- Orc invasion
- Elemental invasion
So now you break certain bits of the world, quest, monster spawning, loot tables in to scenario specific branches
Well use the demon invasion for this sample.
Terrain generation:
Somewhere on your map will be the demon infected land. It gets bigger over time; this creates some stress for the player to solve the quest or elements of the quest in a timely fashion or they become harder to traverse the land because the demon infected land is growing. The growing over time also satisfies some of your need to have differences each time they come in the game, the land is changing as an effect of the plot going on wards.
Well be sterotypical here, since its 'demon' the demon land will be tinted red.
Monster Generation:
In demon infected areas demons will spawn. Demons might show up elsewhere also with a lower percentage but demon infected areas are 'hot spots' for the scenario specific spawns and have the higher level ones as this involves solving the end game content.
NPC/Quest Generation:
When talking to NPC's they have scripts "The (insert scenario) monsters killed my father and took our family sword. Please go to (location x) and kill the (insert scenario guys) and bring it back for a reward".
You of course would have dozens if not hundreds of potential generic quests that let you insert some variables for scenario specific items.
These are your base-line 'foozle' quests. I would suggest a dozen or more 'main quests' that are more involved and include gathering or creating key items for specific scenarios would add a lot of value to the main game also. 'main quests' would mostly not be procedural other than where to find the quest items at perhaps.
End Game Specific:
As previously suggested in your end game you need a little bit of very specific content; this is simply surrounded by some procedural content. The Demon King always lives in a lava cave, but where is it? The Lich King always lives in a ice fortress but which mountain is it on? etc.
This is just the basics, you can add layers of polish, complexity, story telling in different layers of complexity and polish depending on your goals and required game play density for your players.