Solid Tumor: Germ Cell Tumors (Solid Tumor)
Alternate Names: None
- Germ cell tumors include a diverse group of tumors that arise from primitive germinal cells in either the gonads (ovaries, testicles) or non-gonadal sites (brain, chest, tailbone).
- They can be non-cancerous, benign (for example, teratomas), or malignant (examples, choriocarcinoma, endodermal sinus tumor, germinoma) or tumors with a mixture of these components (for example, immature teratoma with endodermal sinus tumor component ).
Germ cell tumors account for 2-4 percent of all pediatric cancers. They occur in two peak periods during childhood:
- Early infancy - in which benign and malignant teratomas (usually extragonadal) are frequent
- Adolescence - in which gonadal tumors are more common
- Germ cell tumors are more common in patients with Klinefelter syndrome or with a history of an undescended testicle.
- Many germ cell tumors produce proteins that can be measured in the blood as tumor markers. The two most commonly elevated tumor markers are alpha-fetoprotein (AFP) and chorionic gonadotropin (HCG). When elevated, their measurement is useful in monitoring the response to treatment, whether it involves surgery, chemotherapy or both.
Clinical Features and Symptoms
- The signs and symptoms of these tumors depend on their location and the effects on normal body functions related to the proteins secreted by the tumor cells. For example, in infants, teratomas near the tailbone present as a visible mass, constipation, or difficulty urinating caused by tumor compression of the bladder or rectum.
- A tumor in the ovary usually presents with enlargement of the lower abdomen.
- A tumor in the testicle presents as a mass in scrotum.
- The treatment of germ cell tumors is based on the stage, location, and the microscopic appearance of the tumor (histology).
- For patients with localized gonadal (ovaries, testis) tumors the long-term survival is excellent (79 percent).
- For completely resected tumors, surgery is usually sufficient to achieve a cure.
- If the tumor has spread to the lymph nodes or other parts of the body, chemotherapy is effective and can produce long-term survival in more than 80 percent of the patients.
Germ cell tumors are very uncommon and many patients are cured with treatment. Ongoing research is focused on shortening the duration of chemotherapy with the hope that excellent survival can be maintained while decreasing the long-term effects of treatment.
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