Rare Tumors Patient & Family Handbook

Germ cell tumors can be malignant or benign. Malignant germ cell tumors include immature teratoma, yolk sac tumor, and choriocarcinoma. They can destroy the testes and ovaries and spread to other parts of the body (metastasis). Benign germ cell tumors include several types of teratomas, which are tumors that contain hair, muscle, and bone. They can be quite large and cause problems as a result of their size.

What are Some of the Signs and Symptoms of Germ Cell Tumors? The symptoms depend on where the germ cell tumor is growing. • Testicular germ cell tumors (in the testes)—These are commonly a painless mass in the scrotum (the skin that holds the testes). Parents may notice the swelling in young boys. Adolescent boys, however, may not report the growth for some time because they are embarrassed about discussing problems with their sex organs. • Ovarian and abdominal tumors—There may be abdominal pain, bloating, constipation, and an enlarged abdomen. • Mediastinal tumors—These are located in the middle section of the chest cavity. Often there are no symptoms at first, but they cause shortness of breath and wheezing when they become large. • Sacrococcygeal teratomas—These are located at the base of the coccyx, or tailbone. They may present as a large mass coming from the rectum and are usually seen at birth.

What Causes Germ Cell Tumors? The causes of germ cell tumors are not known completely. It is known that the tumors occur when cells that normally are sent to the testes or ovaries in the developing fetus fail to reach their destination. Some of these tumors occur in children with extra genetic material or more than the normal number of chromosomes. What Is the Common Treatment and Outcome for Germ Cell Tumors? Factors that affect treatment and cure are: • Location—Germ cell tumors of the testes have a better prognosis because they can be surgically removed. Tumors outside the testes are more difficult to treat. Mediastinal tumors often have no early symptoms and may be difficult to treat later. • Cell characteristics—Benign teratomas have an excellent prognosis with surgical removal. Malignant germ cell tumors require surgery and chemotherapy. • Tumor cell markers—Many tumors produce proteins that are measured in the blood to show tumor growth and treatment success. They can be used to help decide how to treat a tumor. Two examples are AFP and beta human chorionic gonadotropin (bhCG). • Stage—A child whose tumor has spread to different parts of the body requires more treatment. • Age at diagnosis—Patients older than 12–15 years have a poorer outcome than younger patients.

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