Germ cells develop into sperm and eggs, and are mainly found in the ovaries or testicles, although they can develop anywhere in the body that contains germ cells.
In women, most of their ovarian germ cell tumors are benign; approximately 1-2 percent of these masses are malignant. These masses develop in young and adolescent women, or in older women over 60 years of age.
There are a number of different types of germ cell tumors are:
Teratomas: This is the most common type of germ cell tumor found in the ovaries; can be benign or malignant.
Germinomas: Malignant germ cell tumors. Also called dysgerminomas when found in the ovaries and seminoma when found in the testes.
Endodermal sinus tumor (yolk sac tumors): Usually malignant, but sometimes benign.
Most commonly found in the ovary, testes, and sacrococcygeal areas (tail bone, or distal end of spinal column). When found in the ovary or testes, the mass can be very aggressive and spread rapidly to other areas of the body.
- Choriocarcinoma: Very rare, but usually malignant, mass that forms in the placenta during pregnancy.
- Embryonal carcinoma: Malignant cells usually mixed with other types of germ cell tumors that form most often in the testes.
Signs & Symptoms
Symptoms can vary from patient to patient, depending on the location and stage of the mass. Some of the most common symptoms include:
- A swollen mass or tumor that can be seen or felt
- Abnormally high levels of certain chemicals in the blood, mainly alpha-fetoprotein (AFP) and/or beta-human chorionic gonadotropin (β-HCG)
- Constipation, incontinence, or leg weakness, particularly if the tumor is in the sacrum (a portion of the vertebral column that forms the top part of the pelvis)
- Abnormal shape or irregularity in testicle size
Diagnosis & Treatment
There are a number of tests that can detect an abnormality. Among the most common are:
- Complete blood count (CBC): This test measures the size, number, and maturity of different types of blood cells.
- Other blood tests: May include blood chemistries, evaluation of liver and kidney functions, and genetic studies.
- Imaging exams: May include a CT or CAT scan, magnetic resonance imaging (MRI), x-ray, or ultrasound. These tests can take photos of the mass from various angles and show detail in varying amounts. These tests can help to determine the size, location, and stage of the mass.
A biopsy is the only type of test that can give a definitive diagnosis of a germ cell tumor. In this procedure, a small tissue sample is collected and examined under a microscope.
Most germ cell tumors are removed surgically, and for some patients, no further treatment is needed. For patients whose tumors have returned, they may need to undergo chemotherapy in addition to surgery to remove the mass a second time.
Prognosis
A patient’s prognosis depends on the size, location, and stage of the cancer, as well as the patient’s overall health and response to treatment. As with most forms of cancer, it is recommended to seek medical treatment as soon as possible to improve a patient’s chances for a full recovery.