Germ Cell Tumor

A germ cell tumor is a growth that usually starts in your reproductive organs (like your ovaries or testicles). It can be malignant (cancerous) or benign (noncancerous). Germ cell tumors most commonly affect children, teens and young adults.

These growths are made of reproductive cells, also called germ cells. Germ cell tumors don’t have anything to do with the kind of germs that give you a cold or strep throat. Here, “germ” is short for “germinate,” which means to grow or mature. Normally, germ cells grow into eggs or sperm. That’s why germ cell tumors most often form where eggs or sperm are made (ovaries or testicles).

Less commonly, germ cell tumors form in other parts of your body (extragonadal tumors). These include your:

• Back
• Belly (abdomen)
• Brain
• Chest
• Tailbone

Types of germ cell tumors

Germ cell tumors can be made up of one or more types of cells (mixed germ cell tumor). Types include:

• Seminomas and non-seminomas are germ cell tumors that cause testicular cancer. Seminomas often grow and spread slowly. Non-seminomas grow larger and spread more quickly. Non-seminomas include choriocarcinomas, embryonal cell carcinomas, yolk sac tumors and teratomas.
• Choriocarcinomas are rare, cancerous tumors most often found in your uterus. They can spread to other parts of your body and the fetus.
• Germinomas are cancerous tumors that most commonly form in your brain and spinal cord. They can also form in your ovaries or testicles.
• Embryonal cell carcinomas are rare, cancerous tumors. They’re often mixed with other tumor types in a mixed germ cell tumor.
• Polyembryomas are fast-growing, cancerous tumors often mixed with other types of germ cell tumors. They’re made up of parts that look like embryos.
• Teratomas are tumors that contain tissue like teeth, hair, muscle and bone. They can be benign or malignant. Benign teratomas are the most common kind of ovarian germ cell tumor.
• Yolk sac tumors (endodermal sinus tumors) are cancerous tumors made up of cells similar to those in a developing embryo.

Symptoms of germ cell tumors

The symptoms of a germ cell tumor depend on the tumor’s size and where it is in your body. Symptoms could include:

• Pelvic, belly or groin discomfort or pain
• Swollen belly
• Irregular vaginal bleeding
• Nausea
• Solid, firm lump in a testicle (with or without pain) or unusually shaped testicle
• Pain or heaviness in your scrotum
• Back pain
• A growth on your tailbone or chest
• Trouble breathing
• Leg weakness
• Trouble peeing and pooping

Ovarian germ cell tumors don’t always cause symptoms. For instance, teratomas may not cause symptoms until they’re large enough to create pressure in your belly or cause your ovary to painfully twist.

Some germ cell tumors release reproductive hormones that can cause symptoms of early puberty or atypical sexual development in children. Females may develop breasts, grow pubic hair and get their periods early. Males may develop enlarged breast tissue (gynecomastia).

Germ cell tumor causes

Experts aren’t sure what causes germ cell tumors. They form from cells that don’t develop fully into eggs or sperm. These cells divide abnormally and become a tumor instead. They sometimes travel to other places in your body — like your chest, brain, belly, low back and tailbone — and form tumors.

Risk factors

Anyone can have a germ cell tumor, but kids under 4 years old, teens and young adults get them most often. You may be more likely to get a germ cell tumor if someone in your family has had one or if you have:

• Untreated, undescended testicles
• Turner syndrome
• Klinefelter syndrome

How doctors diagnose germ cell tumors

Your healthcare provider will perform a physical exam and ask about symptoms. They may perform the following tests or procedures:

• Blood tests: Your provider may do a blood draw to check the amounts of enzymes, proteins or hormones in your blood. High levels of human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH) may be signs of some germ cell tumors.
• CT scan, MRI or ultrasound: These show images of the inside of your body. They’re often one of the first steps in diagnosing cancer.
• PET scan: This is an imaging test that can show whether cancer has spread.
• Bone scan: This is an imaging test that can show whether a tumor is affecting your bones.
• Biopsy: During a biopsy, a surgeon removes tissue from the tumor and sends it to a lab for testing.

How are germ cell tumors treated?

Treatment options for germ cell tumors might include:

• Surgery: Many germ cell tumors can be cured with surgery. Your provider may remove the tumor from the affected ovary (ovarian cystectomy) or the entire ovary and fallopian tubes (salpingo-oophorectomy). With testicular cancer, your provider will remove the testicle with the tumor during diagnosis.
• Chemotherapy: Chemotherapy uses drugs to destroy cancer cells or prevent them from dividing. You might receive chemotherapy if your provider can’t remove the tumor safely, if it has spread to other parts of your body, or to destroy any remaining cancer cells following surgery.
• Radiation therapy. Radiation therapy uses high-energy X-rays to destroy cancer cells. Some types of germ cell tumors respond best to radiation therapy.

When should I see my healthcare provider?

Talk to your provider if you or your child has symptoms of a germ cell tumor. They’ll recommend any next steps.

What’s the survival rate for a germ cell tumor?

Most germ cell tumors are treatable and have a good survival rate. But the survival rate and treatment options depend on many things, including:

• Your age
• The type of germ cell tumor
• The tumor’s location and size
• Where the cancer’s spread
• How the tumor responds to treatment

Ask your provider what to expect in your specific situation.