Germ cell tumors

Germ cell tumors are derived from the germ cells (reproductive cells). The immature germ cells will be formed as masses of tissues that are called as germ cell tumors. Germ cells are present in the developing embryo that becomes eggs in the ovaries and sperms in the testicles. During the development of the embryo, the germ cells may also travel to other areas of the body and form as tumors. These tumors can be benign or cancerous (malignant). Approximately 3% of childhood cancers are due to germ cell tumors.

Types of Germ Cell Tumors

The germ cells tumors can spread to chest, abdomen, or brain. The tumors that are formed in the brain are called as ‘intracranial germ cell tumors’ and the tumors that are formed outside the brain are called as ‘extracranial germ cell tumors’. The germ cell tumors can be categorized as seminomas (tumors that start in the testicles or ovaries), non-seminomas, and mixed germ cell tumors that have both seminomatous and nonseminomatous tumors.

The cause of germ cell tumors is still not known.

Signs and Symptoms

The symptoms depend on where the tumors develop; it usually starts with formation of a solid mass or lump. The other symptoms include:

  • Pain in the affected area
  • Cough, difficulty in breathing
  • Chest pain and abdominal pain
  • Constipation
  • Frequent urination, urinary retention
  • Early puberty
  • Excessive growth of hair

You doctor may suggest different diagnostic tests depending of the type of tumor suspected, age, medical condition, and symptoms. After general physical examination, you should go for the following tests:

Biopsy: A sample of the tissue from the tumor will be removed and observed under microscope to to check if the tumor is benign or cancerous. X-ray: X-ray of the tumors will be taken by using energy beam CT scan: help to take a detailed picture of the body from different angles. Sometimes dyes may also be injected into the veins to get clear picture of the organs and tissues. MRI: High-frequency magnetic, radio waves are used to takes pictures of the inside parts of the body to measure the size of the tumor. Ultrasound: High energy sound waves are passed into the body which is bounced back to produce echoes; these echoes are used to take pictures of the tissues. Bone Scan: A radioactive material called tracer will be injected to the patient. This material gets accumulated in the tumor, indicating the location of the cancer tumor. Immunohistochemistry Study: It is used to study the difference between the types of cancers. Antibodies or dye or radioisotope are added to the cancer tissue to test for certain antigens.

Staging

Stage I The tumor is small, not spread and can be completely removed by surgery.
Stage II Traces of tumor are still present after the surgery. The traces are microscopic.
Stage III Visible traces are present after the treatment; the lymph nodes are significantly affected.
Stage IV The tumor has spread to other parts of the body.
Recurrent The tumor has come back after the treatment.

The doctor recommends appropriate treatment based on the type, stage of the tumor and alos your health condition.

The following types of surgeries are considered:

Surgery : The germ cell tumor will be completely removed by surgery. Surgery is suggested mostly when the size of the tumor is small. There are different techniques to remove the tumor:
  • Resection: Removing of a part or all of an organ. When the cancer tumor is present in coccyx (bottom portion of the spine), then entire coccyx will be removed.
  • Tumor Debulking: A procedure to remove as much of tumor completely.
  • Radial Inguinal Orchiectomy: One or both the testicles are removed by incision in the groin.
  • Unilateral Salpingo-Oophorectomy: One ovary and one fallopian tube will be removed.
Chemotherapy : Medications will be given orally or injected into the body to destroy the tumor cells. Combinations of anticancer drugs are often used.

Radiation Therapy : High-energy X-rays are used to kill the cancer cells and to stop further growth of the cancer cells. Radioactive substance sealed in needles, wires, or catheters are placed near the tumors to kill the cancer cells.

Follow-up

If you have any concern regarding your child’s health, talk to your doctor immediately. Follow-up the doctor’s appointment without fail and have regular blood tests before and after the treatment because there are chances that tumor might come back and further treatment is required.