Introduction

Germ cell tumors are malignant (cancerous) or nonmalignant (benign, noncancerous) 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.

Causes

The cause of germ cell tumors isn't completely understood. A number of inherited defects have also been associated with an increased risk for 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.

Symptoms

• A tumor, swelling, or mass that can be felt or seen
• Elevated levels of alpha-fetoprotein (AFP)
• Elevated levels of beta-human chorionic gonadotropin (ß-HCG)
• Constipation, incontinence, and leg weakness can occur if the tumor is in the sacrum (a segment of the vertebral column that forms the top part of the pelvis) compressing structures
• Abdominal pain
• Abnormal shape, or irregularity in, testicular size
• Shortness of breath or wheezing if tumors in the chest are pressing on the lungs
• The symptoms of germ cell tumors may resemble other conditions or medical problems. Always consult your child's doctor for a diagnosis.

Diagnosis

• Biopsy
• Complete blood count (CBC
• Additional blood tests
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)
• X-ray
• Ultrasound (also called sonography)
• Bone scans

Treatment

• Surgery (to remove the tumor and involved organs)
• Chemotherapy
• Radiation
• Bone marrow transplantation
• Supportive care (for the effects of treatment)
• Hormonal replacement (if necessary)
• Antibiotics (to prevent or treat infections)

Conclusion

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