|SSM Cardinal Glennon Children's Medical Center|
Germ Cell Tumors
Germ cells are the cells in a developing fetus that eventually produce sperm in males and eggs in females. These cells normally develop along what's called the "midline" of a fetus (usually where the stomach and other internal organs will lie) before finally settling into place in the reproductive organs.
Abnormal groupings of germ cells that cluster together, becoming tumors, tend to develop in the ovaries or testes. Sometimes, though, because germ cells can settle in other places along their way to the reproductive organs, tumors can form in other areas.
The most common sites for germ cell tumors outside of the reproductive tract are the mediastinum (part of the chest between the breastplate and spine), tailbone, abdomen, and pelvis. Some also might develop in the central nervous system (the brain).
Types of Tumors
Like tumors that occur in other places in the body, germ cell tumors can be benign (not cancerous) or malignant (cancerous). There are several different types; each is classified according to the specific types of germ cells present and their location in the body.
The most common germ cell tumors include:
The cause of most germ cell tumors is not well known. Doctors do know that certain medical conditions can make a child more likely to develop a germ cell tumor. These include birth defects that affect the central nervous system, genitals, urinary tract, and spine; as well as certain genetic conditions that result in missing or extra sex chromosomes.
Boys with undescended testicles (testes that remain up inside the pelvis) also appear to be at increased risk.
Early on, a child with a benign or malignant germ cell tumor might have few symptoms or none at all. As the tumor grows, however, a mass may be felt or seen in the abdomen or elsewhere in the body.
Other symptoms include constipation or trouble holding urine if the mass is in the pelvis, leg weakness if the tumor is pressing on the nerves at the base of the spine, and a testicle that is abnormal in shape or size.
A doctor who suspects that a child has a tumor will perform a thorough physical exam in addition to these tests:
Children with benign germ cell tumors will undergo surgery to remove the tumor. Those with malignant tumors will receive treatment after a process called staging.
Staging is a classification system (usually using roman numerals l-lV) that helps doctors determine how far the cancer has progressed. It takes into account things like the size of the tumor (or tumors), how deeply the tumor has penetrated an organ, and whether the tumor has metastasized to nearby or distant organs.
This information, in addition to a child's age and overall heath, helps doctors develop treatment plans that may include the following options, in combination or alone:
The stress of having a child who is being treated for any type of tumor can be overwhelming. And being told that a child has cancer can be a terrifying experience.
To find support for you or your child, talk to your child's doctor or a hospital social worker. Many resources are available to help you get through this difficult time.
Reviewed by: Gregory C. Griffin, MD