Catholic University Catholic Hematology Hospital

Overview

Germ cell tumors start from the cells that are meant to become eggs in girls or sperm in boys. These types of tumors are rare in kids, making up about 3% of all pediatric cancers. While germ cell tumors often develop in the reproductive organs, like the ovaries or testicles, they can also pop up in other places in the body.
When looking at these tumors under the microscope, doctors categorize them into several types:
Teratomas: These can have different kinds of tissues inside, like hair, muscle, or bone.
Germinomas: A type of tumor that's usually more responsive to treatment.
Choriocarcinomas: These grow quickly and can spread to other parts of the body.
Embryonal carcinomas: They're pretty aggressive and can also spread.
Mixed germ cell tumors: These have features of more than one of the other types.
Understanding the specific type of germ cell tumor is crucial because it helps doctors at top cancer centers like MD Anderson, Mayo Clinic, Cleveland Clinic, and Johns Hopkins Medicine to tailor the treatment to give the best chance of beating the cancer.

Causes and Symptoms

The exact causes of germ cell tumors aren't fully understood, but it's thought that a mix of environmental elements and genetic factors might play a part. Environmentally, things like certain chemicals, infections, and even radiation could potentially be involved.

There's also a pattern where kids with birth defects involving the brain, lower spine, or urinary and genital organs have a higher chance of developing these tumors. On top of that, certain changes in the chromosomes of the cells, like having an extra piece of chromosome 12 (that's the 12p isochromosome), or missing parts on chromosomes 1 and 3, have been linked to these tumors. Mutations in genes that are supposed to control cell growth, like the K-ras and N-ras genes, might also be connected.
Understanding these risk factors helps doctors and researchers figure out who might be more likely to get these tumors and how to prevent or treat them.

Treatment

In germ cell tumors, doctors can tell the different types apart by checking the levels of certain substances in the blood, like alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-HCG). These are called serum biochemical tumor markers.

The main ways to treat these tumors are with surgery and chemotherapy. If it's possible to remove the whole tumor with surgery, that's typically the first step. But if taking out the tumor means removing a lot of healthy tissue too, doctors have to really think about how to keep as much normal function as possible. They'll consider how urgent the situation is and the patient's overall health before deciding to go ahead with a big surgery. If they can't take out the whole tumor right away, they'll usually do a biopsy first, then use chemotherapy and sometimes radiation therapy to shrink the tumor before trying surgery.

Chemotherapy is a powerful tool that can get rid of visible tumors and any tiny cancer cells that might have spread to other parts of the body. It helps to stop the cancer from spreading further and can make it more likely that surgery will get rid of all the cancer.