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.