Germ Cell Tumor (Childhood Extracranial)

As a fetus develops, certain cells form sperm in the testicles or eggs in the ovaries. Sometimes these cells travel to other parts of the body and grow into germ cell tumors. This summary is about germ cell tumors that form in parts of the body that are extracranial (outside the brain). Extracranial germ cell tumors are most common in teenagers 15 to 19 years old. There are three types of extracranial germ cell tumors- extracranial germ cell tumors are grouped into mature teratomas, immature teratomas, or malignant germ cell tumors:

Mature Teratomas: Mature teratomas are the most common type of extracranial germ cell tumor. The cells of mature teratomas look very much like normal cells. Mature teratomas are benign and not likely to become cancer.

Immature Teratomas: Immature teratomas have cells that look very different from normal cells. They are more likely to become cancer.

Malignant Germ Cell Tumors: Malignant germ cell tumors are cancer. There are three types of malignant germ cell tumors:

  • Yolk sac tumors: Tumors that make a hormone called alpha-fetoprotein (AFP).
  • Germinomas: Tumors that make a hormone called beta-human chorionic gonadotropin (ß-hCG).
  • Choriocarcinomas: Tumors that make a hormone called beta-human chorionic gonadotropin (ß-hCG).

 

 

Stages of Germ Cell Tumor (Childhood Extracranial)

 

Stage I extracranial germ cell tumors: In stage I, the cancer is in one place and can be completely removed by surgery.

Stage II extracranial germ cell tumors: In stage II, the cancer has spread to nearby tissues or lymph nodes and is not completely removed by surgery. The cancer remaining after surgery can be seen with a microscope only.

Stage III extracranial germ cell tumors: In stage III, the cancer:

  • has spread to nearby tissues and lymph nodes.
  • is found in fluid in the abdomen or around the lungs.
  • is not completely removed by surgery. The remaining cancer can be seen without a microscope.

Stage IV extracranial germ cell tumors: In stage IV, the cancer has spread to other places in the body, such as the lung, liver, brain, bone, and distant lymph nodes.

 

Treatment of Germ Cell Tumor (Childhood Extracranial)

 

Surgery

Surgery to completely remove the tumor is done whenever possible. If the tumor is very large, chemotherapy may be given first, to make the tumor smaller and decrease the amount of tissue that needs to be removed during surgery. The following types of surgery may be used:

  • Resection: Surgery to remove tissue or part or all of an organ. If cancer is in the coccyx, the entire coccyx is removed.
  • Tumor debulking: A surgical procedure in which as much of the tumor as possible is removed. Some tumors may not be able to be completely removed.
  • Radical inguinal orchiectomy: Surgery to remove one or both testicles through an incision (cut) in the groin.
  • Unilateral salpingo-oophorectomy: Surgery to remove one ovary and one fallopian tube.

Watchful waiting

Watchful waiting is closely monitoring a patient’s condition without giving any treatment until symptoms appear or change. For childhood extracranial germ cell tumors, this includes physical exams, imaging tests, and tumor marker tests.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is treatment using more than one anticancer drug. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

 

New types of treatment are being tested in clinical trials.

 

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Search for clinical trials in Georgia.

Adapted from the National Cancer Institute's PDQ Database: http://www.cancer.gov/cancertopics/pdq/treatment/extracranial-germ-cell/patient. (Accessed July 2016)