Germ cell tumors are masses of tissue formed by immature
cells that normally would have developed into mature eggs (in a female) or
sperm (in a male).
Although germ cell tumors are rare in children under age 15,
they are the most common solid tumors in adolescents, accounting for 14% of all
cancers among those 15-19 years old.
cell tumors of the brain are a type of extragonadal germ cell tumor, but are
treated differently than germ cell tumors in other parts of the body. This page
is focused on extracranial (outside of the brain) germ cell tumors.
Children with germ
cell tumors are treated at Dana-Farber/Boston Children's through our Solid
Tumor Center. Our specialists have extensive expertise in treating even the
rarest of pediatric tumors, including germ cell tumors. Our solid tumor treatment team includes medical oncologists,
surgical oncologists, radiation oncologists, and pediatric subspecialists who
have unique expertise in treating germ cell tumors.
Successfully treating your child’s germ cell tumor depends
on where the tumor is located and whether it is benign or malignant. There are three
main types of germ cell tumors: teratomas (mature and immature), seminomas and
non-seminomas (including yolk sac tumors).
Germ cell tumors can cause a
variety of symptoms in children based primarily on the size and location of the
tumor. Keep in mind that the symptoms of a germ cell tumor may resemble other
more common conditions or medical problems. It is important to consult your
child's physician for a diagnosis.
Each child may experience germ cell
tumor symptoms differently, but your child's symptoms may include:
As a parent, you undoubtedly want to know what may have
caused your child’s germ cell tumor. Doctors do
not understand the cause of most germ cell tumors. Scientists do know that they
can be associated with a number of other inherited defects of the ovaries or
testes. For example, patients with Klinefelter syndrome have an increased risk
of developing extragonadal germ cell tumors.
However, it’s important to understand that germ cell tumors most often
occur with no known cause. There’s nothing that you could have done or avoided
doing that would have prevented the tumor from developing.
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
Your child’s physician may order a number of different diagnostic
tests for germ cell tumors, including:
There may be other diagnostic tests that your doctor will discuss with
you depending on your child's individual situation. After we complete all
necessary tests, our experts meet to review and discuss what they have learned
about your child's condition. Then we will meet with you and your family to
discuss the results and outline the best possible treatment options.
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:
If the tumor is malignant (cancerous), treatment may also include:
Various research studies are underway to help build our
understanding of how treatment types and dosages can be modified according to
the tumor sub-type, stage, location on the body and the age and gender of the
child – to provide the best possible outcome.
Due to the rarity of germ cell tumors in children, however,
statistically meaningful data with multivariate analysis is difficult to
achieve. To address that, the Malignant Germ Cell International Collaborative
(MaGIC) was formed. This consortium, led by A.
Lindsay Frazier, MD, a pediatric oncologist at Dana-Farber/Boston
Children’s, is a collaboration of the world’s experts in germ cell tumors, including
pediatric, gynecologic and genito-urinary oncologists.
For many children with rare or
hard-to-treat conditions, such as germ cell tumors, clinical trials – research studies evaluating new treatment
approaches – provide new options.
Participation in any clinical trial is completely voluntary. We will
take care to fully explain all elements of the treatment plan prior to the
start of the trial, and you may remove your child from the medical study at any
Survival rates for children with germ cell tumors have increased
significantly in the last several decades. This is largely due to findings 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% 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.
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. In addition to
meeting with your pediatric oncologists, your child may see one of our
endocrinologists, cardiologists, neurologists, neuro-psychologists or
alternative/complementary therapy specialists. We
also provide patient and family education, psychosocial
assessment, genetic counseling, reproductive and fertility evaluation and
counseling and opportunities to speak with other childhood cancer survivors.
Phone: 617-632-5508Online form: Request an appointment
U.S. News & World Report ranked Dana-Farber/Boston Children's the #1 pediatric cancer hospital in the nation.