• Germ Cell Brain Tumors in Children

    Germ cell brain tumors develop when germ cells that should normally form the ovaries or testes fail to migrate and become “trapped” in the brain. When they are found in the brain, they’re called intracranial germ cell tumors, or germ cell tumors of the brain.

    There are four main types of germ cell tumors of the brain:

    • Pure germ cell tumors, or germinomas, are immature (underdeveloped) tumors that respond well to treatment
    • Non-germinomatous germ cell tumors, which secrete chemicals into the spinal fluid and bloodstream and require more aggressive treatment than pure germ cell tumors
    • Teratomas, which are benign lesions derivered from germ cells that are cured with surgery

    Mixed germ cell tumors which can have a mixture of any of the following: benign germ cells (teratomas),germinomas and non-germinomatous germ cells.

    Note: Germ cell tumors can also occur in other parts of the body; those germ cell tumors require different treatment than germ cell tumors of the brain. This page is focused on germ cell tumors of the brain.

    Germ Cell Brain Tumor Treatment at Dana-Farber/Boston Children's

    Children with germ cell brain tumors are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through the Brain Tumor Center. Continue reading to learn more about germ cell tumors of the brain or visit the Brain Tumor Center homepage to learn about our expertise with this condition.

    Symptoms & Diagnosis

    Germ cell tumors of the brain are rare and can range from benign lesions to highly malignant, aggressive cancers. For tumors in the pineal gland region, children can have the following symptoms:

    • Hydrocephalus (swelling of the brain)
    • Headache
    • Vomiting
    • Fatigue
    • Behavioral or cognitive changes
    • Uncoordinated body movement (ataxia)
    • Vision changes, including double vision and difficulty looking up

    For tumors in the pituitary gland region, common symptoms include:

    • Diabetes insipidus (an uncommon disorder characterized by intense thirst and the excretion of large amounts of urine)
    • Delayed puberty
    • Early (precocious) puberty
    • Stunted growth
    • Decreased vision

    Like other brain tumors, diagnostic procedures for germ cell tumors of the brain can determine the exact type of tumor and whether it has spread. In addition to a physical exam, germ cell tumors are diagnosed with:

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    Neurosurgery is the first step in treating most germ cell tumors of the brain. This may include complete removal of the tumor or partial removal if its location warrants, while preserving neurological function.

    Other treatments include:

    There can be side effects related to the tumor itself or its treatment. Knowing what these side effects are can help physicians prepare for and, in some cases, prevent these symptoms from occurring.

    Progressive or Recurrent Disease

    Only a minority of patients will develop a recurrence. A combination of chemotherapy and radiation therapy is usually used to treat recurrences.

    Long-term Outlook

    The prognosis for children with germ cells tumor of the brain largely depends on the type of tumor. Combination radiation and chemotherapy cures approximately 90-95 percent of children with pure germ cell tumors, and mature teratomas are curable when completely removed with surgery. Mixed germ cell tumors have a 70 percent to 85 percent cure rate, depending on their spread at diagnosis.