Germ cell tumors are malignant (cancerous) or nonmalignant (benign, noncancerous) tumors that are comprised mostly of germ cells. Germ cells are the cells that develop in the embryo (fetus, or unborn baby) and become the cells that make up the reproductive system in males and females. These germ cells follow a midline path through the body after development and descend into the pelvis as ovarian cells or into the scrotal sac as testicular cells. Most ovarian tumors and testicular tumors are of germ cell origin. The ovaries and testes are called gonads.

The cause of germ cell tumors isn't completely understood. A number of inherited defects have also been associated with an increased risk for developing germ cell tumors including the central nervous system and genitourinary tract malformations and major malformations of the lower spine. Specifically, males with cryptorchidism (failure of the testes to descend into the scrotal sac) have an increased risk to develop testicular germ cell tumors. Cryptorchidism can occur alone, however, and is also present in some genetic syndromes.

Some genetic syndromes caused by extra or missing sex chromosomes can cause incomplete or abnormal development of the reproductive system.

Symptoms of this tumor are:

• A tumor, swelling, or mass that can be felt or seen
• Elevated levels of alpha-fetoprotein (AFP)
• Elevated levels of beta-human chorionic gonadotropin (ß-HCG)
• Constipation, incontinence, and leg weakness can occur if the tumor is in the sacrum (a segment of the vertebral column that forms the top part of the pelvis) compressing structures
• Abdominal pain
• Abnormal shape, or irregularity in, testicular size
• Shortness of breath or wheezing if tumors in the chest are pressing on the lungs

The symptoms of germ cell tumors may resemble other conditions or medical problems. Always consult your child's doctor for a diagnosis.

Germ cell tumors diagnosed:

 Biopsy: A sample of tissue is removed from the tumor and examined under a microscope.   Complete blood count (CBC): This measures size, number, and maturity of different blood cells in a specific volume of blood.

  Additional blood tests: These tests may include blood chemistries, evaluation of liver and kidney functions, tumor cell markers, and genetic studies.

    Multiple imaging studies, including:

        Magnetic resonance imaging (MRI): This is a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body, without the use of X-rays.

        X-ray: This diagnostic test uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

        Ultrasound (also called sonography): This is a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.

        Bone scans: This involves pictures or X-rays taken of the bone after a dye has been injected that's absorbed by bone tissue. These are used to detect tumors and bone abnormalities.

Treatment:

• Your child's age, overall health, and medical history
• Extent of the disease
• Your child's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

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