A germ cell tumor is a neoplasm that is comprised of germ cells found in the ovaries and testes.
Extragonadal germ cell tumors are the same type of tumors, just located somewhere outside of the ovaries and testis. They are found in people of all ages, but are primarily seen in young males.
Extragonadal germ cell tumors can be either benign or malignant. 90% of malignant tumors are found in males. These are a relatively rare type of tumor.
Common areas they are found are on the mediastinum (chest area) and the retroperitoneum (abdominal area). Sacrococcygeal teratoma is a common type of extragonadal germ cell tumor diagnosed in babies when they are born.
There is some controversy as to the origin of these tumors. It was originally believed that they had metastasized from cancerous cells in the ovaries or testis, but today it is believed that they originate in the area where the tumor is found.
Signs and Symptoms
Signs and symptoms of extragonadal germ cell tumors depends largely on where the tumor is located, its size, and whether or not it is obstructing or pressing against surrounding organs. Non-specific symptoms can include weight loss, nausea and fatigue. Tumors in the chest area can cause chest pain, cough and trouble breathing.
Diagnosis
There are many tumor markers that doctors can use to diagnose an extragonadal germ cell tumor. Since this is a rare type of tumor they must also differentiate it from other types of tumors. Blood tests, physical exams and scans of the abdomen, chest and pelvis, are used to provide doctors with more information about the tumor.
A biopsy of the cells will also be done. Once they have all of the information the tumor will be staged. There are different staging methods used, depending on if the patient is a child or an adult.
Treatment
Many different treatment combinations have been tried for extragonadal germ cell tumors. No single treatment plan has proven effective in every case. Most treatment plans include a combination of surgery, chemotherapy and radiation. Chemotherapy and radiation treatments may be given before surgery, after surgery, or both.
For some patients surgery leads to their extragonadal germ cell tumor being cured. For other patients surgery can be dangerous due to the location of the tumor or its growth into surrounding tissues. Some types of extragonadal germ cell tumors are more responsive to chemotherapy and radiation that others.
Prognosis
Just as with treatment, prognosis for extragonadal germ cell tumors varies greatly depending on the size, location and stage of the tumor. We do know that prognosis has greatly improved in recent years due to advances in diagnosing, treating, and even curing, these tumors. They can recur and patients can experience complications as a result of their treatment, but with careful and frequent follow-up prognosis can be very good.
