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Pediatric Germ Cell Tumors


Germ cell tumors in children are growths that typically develop from reproductive cells in the ovaries in girls and in the testes in boys. In addition to gonadal germ cell tumors, the growths can occur in several other parts of the body, including the lower back, abdomen, chest, and inside the brain.

Germ cell cancers are not common, which is why it is critical to choose a medical center with top tier technologies and specialists who are experienced in diagnosing and treating the disease. At Sheba, every treatment program for children with germ cell tumors is custom designed at our Pediatric Hemato-Oncology Division, using the latest techniques and based on an integrative approach to healing. Depending on where the tumor is located, our hemato-oncologists collaborate with pediatric specialists from the Urology Department, Gynecology Department and the Surgery Division.

pediatric germ cell tumors

About Germ Cell Tumors

Germ cell tumors are considered rare, accounting for approximately 4% of all cases of pediatric cancer. They can be benign or cancerous, and while both types can grow, only malignant tumors can spread to other organs.

In boys, the incidence of germ cell tumors peaks at around two years old, then declines and only increases again in adolescence. In girls, diagnosis of germ cell tumors is rare until about age 6, and then it rises until about age 15. The overall prognosis for children diagnosed with germ cell tumors has approximately a 93% survival rate, and that rate rises to 99% with regard to gonadal germ cell tumors specifically.

What are the Risk Factors for Germ Cell Tumors?

The following factors have been associated with a higher risk for children to develop a gonadal germ cell tumor.
  • Cryptorchidism: An undescended testicle raises the risk for a boy to develop a testicular germ cell tumor.
  • Turner syndrome: This genetic condition, which occurs in girls, is linked to a higher chance of developing a benign germ cell tumor that can eventually become cancerous.
  • Intersex conditions: Androgen insensitivity, which involves resistance to male hormones called androgens, increases the risk of developing a gonadal germ cell tumor.
  • Klinefelter syndrome: This genetic condition that occurs in males is linked to a higher risk of a germ cell tumor in the chest.

What are the Symptoms a Germ Cell Tumor?

The symptoms of a germ cell tumor depend largely on where the growth develops. Usually, a lump appears and causes pain. Sometimes, the lump can be felt immediately, or it may lead to pain in other nearby areas. When it is a gonadal germ cell tumor, there may also be early development of public hair, breast enlargement or vaginal bleeding at a very young age.

A germ cell tumor that is extragonadal (and not located in the brain) may cause the following symptoms:
  • Pain in the affected area
  • Urinary retention
  • Cough and/or trouble breathing, respiratory distress
  • Constipation

What are the Types and Stages of Germ Cell Tumors?

There are several types of germ cell tumors, categorized by their pathology:

  • Benign teratoma
  • Malignant teratoma
  • Yolk sac tumor
  • Choriocarcinoma
  • Embryonal carcinoma
  • Germinoma

The staging of these tumors describes where the tumor is located, if it has spread and whether or not it is affecting other parts of the body. Diagnostic tests are used to determine the stage, and Sheba’s doctors use the stage to help design the best personalized treatment program.

These pathologic stages are used for germ cell tumors:

  1. Stage I: The tumor has been entirely removed, and tumor markers have returned to normal.
  2. Stage II: Tumor was removed, but microscopic traces of the tumor are still present after surgery.
  3. Stage III: Visible traces of tumor are evident in the lymph nodes.
  4. Stage IV: The tumor has spread to other areas of the body, such as the lungs or liver.

  5. Recurrent: The tumor has come back after treatment.

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Sheba Medical Center provides innovative, personalized medical care to patients from around the world. We are the largest, most comprehensive hospital in the Middle East and dedicated to providing advanced and compassionate medicine for everyone. We welcome all cases, including the rarest and the most challenging. Our medical teams collaborate to provide the best possible health outcomes. From your initial inquiry through the long-term follow-up care, we are here for you.

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