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Germ Cell Tumors Diagnosis and Staging

Germ cell tumors are a subtype of tumor that grows from germ cells, which when healthy develop into sperm in boys and eggs in girls. If germ cells go through abnormal growth, they can create a tumor that typically affects the testicles or ovaries, and in some rare cases other organs and tissues if it’s an extragonadal germ cell tumor.

These tumors can occur at any age but are overall very rare. They can be both beginning and malignant, meaning they can be non-cancerous and cancerous. 

If you want to learn more about this specific type of tumor, how it’s diagnosed, and all of its different stages, we have prepared a useful guide.

Germ Cell Tumor Diagnosis

For a doctor to diagnose a germ cell tumor, they will have to perform a variety of tests so they can be completely sure they’ve reached the correct diagnosis.
Other tests on this list can determine whether or not a tumor is present, only a biopsy can show with certainty that the patient has a germ cell tumor, and which type.

To perform a biopsy, the doctor will remove a small amount of tissue or fluid from the tumor, and then a pathologist examines this sample under a microscope. They will look for any abnormalities in the cells and take their entire structure into account.

After the biopsy, the medical professionals in charge of the patient’s case will know which subtype of germ cell tumor the patient is suffering from and whether it’s benign or malignant.

Blood Tests

When going through the germ cell tumor diagnosis process, the doctor will most likely order a blood test. This is done to check the patient’s blood counts, and kidney and liver functions. However, another reason why a blood test may be done is to check the AFP and bHCG levels. In some germ cell tumors, these hormones are significantly increased, and blood test results could indicate the presence of germ cell tumors.

Imaging Tests

One of the simplest ways to explain a tumor would be to present it as a mass, and if a doctor wants to check for the presence of a mass, they can do so with the use of imaging tests.

Imaging tests help locate the tumor and provide information about its shape and size, allow doctors to determine staging, and play a big role in treatment planning.

Imaging tests used for germ cell tumor diagnosis include:

  • Bone scan. In some rare cases, a germ cell tumor might spread to the bones and bone marrow, and to check whether that happened, the doctor will order a bone scan.

  • Computed tomography (CT) scan. This imaging test is able to take cross-sectional images of the entire body, and it’s usually used when the doctor is trying to determine what stage the disease is in and if/how much it's spread.

  • Magnetic resonance imaging (MRI). An MRI machine uses magnetic fields to create images of the patient’s body, and is especially useful for characterizing soft tissue tumors.

  • Ultrasound. If the doctor suspects that the tumor is located in the abdomen, testicles, or ovaries, the doctor may perform an ultrasound to check for the presence of a tumor.

  • X-ray. One of the areas of the body where germ cell tumors spread frequently is the lungs, and the best way to check for lung metastases is to perform an X-ray scan of the chest.

Other Tests

While the tests we previously mentioned are used for diagnosing germ cell tumors, they aren’t enough to provide doctors with all of the information they need to assess the extent of the disease.

Those tests include:

  • Baseline hearing evaluation. This test is done to check the patient’s hearing, and this is done because one of the potential side effects of high-intensive chemotherapy is hearing loss. For this, the doctor will do a baseline hearing evaluation before and after treatment.

  • Nuclear medicine GFR test. Another potential side effect of germ cell tumor treatment is kidney function damage. To check the patient’s kidneys, a doctor will perform a nuclear medicine GFR test that gives insight into the overall health of the kidneys.

  • Pulmonary function test. This test is used to check the patient’s lungs and to see whether the tumor has spread to this part of the body. It’s also used to see whether the treatment is affecting the patient's overall lung health.

Germ Cell Tumor Staging

To determine how much a tumor has progressed, the doctor will classify it into one of 4 stages:

Stage 1 germ cell tumor - The tumor is still where it originally appeared and hasn’t spread.
Stage 2 germ cell tumor - The tumor has spread from the original site but is still located within the pelvis.
Stage 3 germ cell tumor - The tumor has spread to an area away from the original site.
Stage 4 germ cell tumor - The tumor has spread to more distant tissues and organs.

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