What is a Germ Cell Tumour?
Germ cells are the cells that become an embryo, which develops
into a child in the uterus. Some of these cells remain in different
parts of a child's body after birth and may produce tumours. Some
tumours produced by germ cells are benign and some are malignant.
Germ cell tumours may appear at any age. The most common sites for
germ cell tumours to develop are the testes, ovaries, in the middle
of the brain, chest and abdomen and the area at the bottom of the
spine (sacrococcygeal region). There are different names for the
tumour, depending on where or what cell type, e.g. Yolk sac tumour
or teratoma.
Signs and symptoms
Symptoms vary depending on where the tumour is, but usually a
lump appears or can be felt.
Diagnosis
To diagnose a germ cell tumour a biopsy of the tumour is done. Some of these tumours produce alpha-fetoprotein (AFP) and human chorionic gonadotrophin (βhCG) which can be measured by blood tests. Other tests, including a CT, MRI scan or ultrasound will be done to see whether the tumour has spread to other parts of the child's body.
Treatment
If the tumour can be removed by surgery, then this will cure a benign tumour and some malignant tumours. If the tumour is in the testes or ovary, it is often necessary to remove the entire testis or ovary. If cells of a malignant tumour have spread to other parts of the body chemotherapy will also be required. Chemotherapy is sometimes given prior to surgery, particularly in sacro-coccygeal tumours, or if metastases are present at diagnosis. Outcomes after treatment of germ cell tumours in children are usually very favourable.
Follow-up care
During and following treatment the child will have regular blood tests to measure the levels of AFP and βhCG. A high level may suggest that the tumour has not been cured or has recurred, and further treatment may be needed. After the first few years the focus of follow up changes to monitoring growth and development and other possible later side effects of treatment.