What is a germ cell tumour?
A germ cell tumour is one that starts in the reproductive cells, or cells that produce eggs/sperm. The tumours therefore usually begin in the testicles or ovaries. They can also appear in other parts of the body such as the bottom of the spine. This happens whilst the baby is still developing inside the womb. The germ cell travels to the wrong part of the body and can, over time, reproduce to form a tumour. These tumours are called “extragonadal germ cell tumours’

There a many different types of germ cell tumour and they can be benign (not cancer) or malignant (cancer). Those found in children are different to those found in adolescents and young adults. Germ cell cancers are classified according to the type of cell they began from, where they are located and at what age the child is.

Who do they affect?
They can affect children and adolescents.

What are the symptoms?
There are often few symptoms of germ cell tumours other than a lump which can be felt, or which has caused other problems.

How are they diagnosed?
A biopsy will be taken to determine the type of tumour, and a MRI or CT scan will be used to see the size and spread of the disease. A blood test will also be used because germ cell tumours produce proteins that can be measured in the blood.  These are called tumour markers. 

How are they treated?
Germ cell tumours are treated using surgery, chemotherapy or both. The combination of therapies will be determined by the location, the size and spread of the tumour and the age of the child. Surgery can remove the tumour, but may also remove the affected testicle or ovary.  If the tumour is completely removed that may be the only treatment necessary. Chemotherapy may be given if the tumour cannot be removed surgically or if it has spread.

Side-effects
The side-effects associated with chemotherapy are tiredness, sickness and diarrhoea, temporary hair loss and infection, all of which can be managed with help from the child’s Consultant or nursing team. 

After treatment
Children who have only one ovary or testicle may still be able to have children of their own in the future. Parents can ask their child’s Consultant about any future fertility issues that may occur. Some children may go on to develop other longer term side effects. Please remember that all children are different and only a small number develop long-term problems as a result of their treatment. Parents can talk to their child’s Consultant if they are concerned about them.

Follow-up care
All children will need to be monitored regularly at an outpatient's clinic. The Consultant will be looking for any signs that the cancer has returned (recurrent cancer) and checking the functions of major organs to make sure that they have not been affected by the cancer treatment.  Tests will be carried out to monitor any raised levels of tumour markers, which may indicate that the tumour has returned, in which case, further treatment can be given.

Source: www.clicsargent.org.uk