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.


Germ cells are unique cells found in a developing embryo (also called the fetus), which grow to form the eggs in a girls’ ovaries or the sperm in boys’ testicles. Sometimes, during fetal development, these cells travel to other areas of the body and turn into a tumor – a mass that is created when normal cells mutate and grow uncontrolled. Germ cell tumors that form outside the reproductive organs are known as extragonadal 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.

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
  • Cough and/or trouble breathing, respiratory distress
  • Urinary retention
  • Constipation

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.

What are Germ Cell Tumors??

Germ cells are unique cells found in a developing embryo (also called the fetus), which grow to form the eggs in a girls’ ovaries or the sperm in boys’ testicles. Sometimes, during fetal development, these cells travel to other areas of the body and turn into a tumor – a mass that is created when normal cells mutate and grow uncontrolled. Germ cell tumors that form outside the reproductive organs are known as extragonadal tumors.

 

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
  • Cough and/or trouble breathing, respiratory distress
  • Urinary retention
  • 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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