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Germ Cell Tumors

What are germ cell tumors?

Germ cells tumors are malignant (cancerous) or non-malignant (benign, non-cancerous) tumors that are comprised mostly of germ cells. Germ cells are the cells that develop in the embryo (fetus, or unborn baby) and become the cells that make up the reproductive system in males and females. These germ cells follow a midline path through the body after development and descend into the pelvis as ovarian cells or into the scrotal sac as testicular cells. Most ovarian tumors and testicular tumors are of germ cell origin. The ovaries and testes are called gonads.

Tumor sites outside the gonad are called extragonadal sites. The tumors also occur along the midline path and can be found in the head, chest, abdomen, pelvis, and sacrococcygeal (lower back) area.

Germ cell tumors are diagnosed in about 900 children each year. Germ cell tumors account for 16 percent of all cancers diagnosed in adolescents between the ages of 15 and 19 years old, and nearly 4 percent of cancers diagnosed in children younger than 15 years old.

Germ cell tumors can spread (metastasize) to other parts of the body. The most common sites for metastasis are the lungs, liver, lymph nodes, and central nervous system. Rarely, germ cell tumors can spread to the bone, bone marrow, and other organs.

What causes germ cell tumors?

The cause of germ cell tumors is not completely understood. A number of inherited defects have also been associated with an increased risk of developing germ cell tumors including the central nervous system and genitourinary tract malformations and major malformations of the lower spine. Specifically, males with cryptorchidism (failure of the testes to descend into the scrotal sac) have an increased risk to develop testicular germ cell tumors. Cryptorchidism can occur alone, however, and is also present in some genetic syndromes.

In addition, cells from testicular germ cell tumors can have structural chromosome abnormalities involving chromosome #12, which may explain the uncontrolled cell growth and tumor formation.

Some genetic syndromes caused by extra or missing sex chromosomes can cause incomplete or abnormal development of the reproductive system.

What are the symptoms of germ cell tumors?

The following are the most common symptoms of germ cell tumors. However, each child may experience symptoms differently. Symptoms vary depending on the size and location of the tumor. Symptoms may include:

The symptoms of germ cell tumors may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

How are germ cell tumors diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for germ cell tumors may include:

What are the different types of germ cells?

Diagnosis of germ cell tumors depends on the types of cells involved. The most common types of germ cell tumors include:

Many germ cell tumors have multiple types of cells involved. The diagnosis, treatment, and prognosis are based on the most malignant of the cells present and the majority type of cells that are present.

Treatment for germ cell tumors:

Specific treatment for germ cell tumors will be determined by your child's physician based on:

Treatment may include (alone or in combination):

Long-term outlook of a child with a germ cell tumor:

Prognosis greatly depends on:

As with any cancer, prognosis and long-term survival can vary greatly from individual to individual. Prompt medical attention and aggressive therapy are important for the best prognosis. Continuous follow-up care is essential for a child diagnosed with a germ cell tumor. Side effects of radiation and chemotherapy, as well as second malignancies, can occur in survivors of germ cell tumors. New methods are continually being discovered to improve treatment and to decrease side effects.

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