Germ Cell Tumors | Diagnosis & Treatment

How are germ cell tumors diagnosed?

The first step in treating your child is forming an accurate and complete diagnosis. Some germ cell tumors can be seen on a prenatal ultrasound. After birth, they are typically diagnosed using a combination of imaging and biopsy.

Your child’s physician may order a number of different diagnostic tests for germ cell tumors, including:

  • prenatal ultrasound
  • a physical exam and complete medical history
  • biopsy, which involves taking a sample of the tumor's tissue and analyzing it under a microscope
  • a complete blood count, an analysis of your child's blood that involves measuring the size, number and maturity of different blood cells within a set volume of blood
  • additional blood tests may include blood chemistries, genetic testing and an evaluation of liver and kidney function
  • magnetic resonance imaging (MRI), a diagnostic procedure that produces detailed images by using a combination of large magnets, radiofrequencies and a computer to analyze organs and structures within the body
  • computerized tomography scan (CT or CAT scan), a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images, often called slices, of the body from horizontal and vertical perspectives
  • X-ray a diagnostic test that uses invisible energy beams to produce images of internal tissues, bones and organs on film
  • ultrasound/sonography, an imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs

There may be other diagnostic tests that your doctor will discuss with you depending on your child's individual situation.

What are the treatment options for germ cell tumors?

Your child's physician will determine a specific course of germ cell tumor treatment based on several factors, including your child's age, overall health and medical history and the type, location, and size of the germ cell tumor. Germ cell tumor treatment generally includes surgery. Pediatric surgeons will biopsy the tumor and attempt to remove it./p>

If the tumor is malignant (cancerous), treatment may also include:

What is the long-term outlook for children with germ cell tumors?

Survival rates for children with germ cell tumors have increased significantly in the last several decades. This is largely due to results from germ cell tumor clinical trials, some of which build off of effective treatments developed for adults with testicular germ cell tumors. As physician scientists continue to build our understanding of the molecular mutations within germ cell tumors, treatments tailored to the specific characteristics of each child’s tumor may be developed, which could further improve survival rates.

Survival rates vary depending on the particular type of germ cell tumor and the stage of disease (how far it has progressed) when diagnosed. Overall, the survival is close to 90 percent for most children. Certain patients with more advanced disease have a worse prognosis and these patients in particular may want to consider enrollment in a clinical trial. Mature and immature teratomas can usually be surgically removed, The surgery should be done by an experienced surgeon to minimize possible long-term effects of surgery. Chemotherapy for malignant germ cell tumors, however, may result in various late effects (side effects that appear later in adulthood), such as partial loss of hearing, cardiovascular concerns, or a secondary cancer later in life.

Children treated for a malignant germ cell tumor should visit a cancer survivorship clinic every year to manage disease complications, screen for recurrence and manage late treatment side effects. A typical follow-up visit is likely to include a physical exam, laboratory testing and imaging scans. The David B. Perini Jr. Quality of Life Clinic at Dana-Farber provides care and advocacy for survivors of childhood cancer, conducting research on the long-term effects of cancer treatments, and offering education and support for survivors of cancer.