In this section
Germ cells are the cells that become an embryo, which develops
into a child in the womb. 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, eg. Yolk sac tumour
Symptoms vary depending on where the tumour is, but usually a
lump appears or can be felt.
To diagnose a germ cell tumour a biopsy of the tumour is done.
These tumours produce alpha-fetoprotein (AFP) and human chorionic
gonadotrophin (HCG) which can be measured by blood tests. Other
tests, including a chest X-ray, a bone scan, a CT, MRI scan or
ultrasound and a bone marrow aspiration will be done to see whether
the tumour has spread to other parts of the child's body. (Refer to
section on tests and procedures)
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 necessary to remove the entire testicle or
ovary. If cells of a malignant tumour have spread to other parts of
the body chemotherapy will also be required. Often chemotherapy is
given prior to surgery, particularly in sacro-coccygeal tumours, or
if metastases are present at diagnosis.
During and following treatment the child will have regular blood
tests to measure the levels of AFP and HCG. 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.