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There are many different types of germ cell tumors. And not all of them are cancer.

If you’ve found out your child has one of these rare tumors, cancerous or not, it can be very unsettling. These tumors develop in your child’s germ cells, which become eggs or sperm in a fetus. The term “germ cell” comes from the word “germinate,” which means to give life or to grow. When these cells grow out of control, a tumor can develop in your child’s ovary or testicle. Sometimes, they can also go rogue and form in their chest, belly, low back, tailbone or even brain. These are called extragonadal tumors.

No one knows for sure exactly why germ cell tumors form, but the specialists at Cleveland Clinic Children’s are experts at diagnosing and treating them. They also understand all the little ways having a serious illness can affect a child or teen emotionally and are ready to support your whole family throughout this journey.

Why Choose Us for Germ Cell Tumor Care?

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Caring approach:

Germ cell tumors may be cancerous or noncancerous. Either way, finding out your child has one can be unsettling. At Cleveland Clinic Children’s, we’ll provide personalized care and compassionate support for your whole family, from diagnosis throughout treatment and beyond.

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Trusted experts:

Our board-certified pediatric cancer specialists and pediatric surgeons have decades of experience diagnosing and treating all cancers in children, including rare and complex ones like germ cell tumors. Meet our team.

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Innovation and research:

Our providers are national leaders in the research and development of treatments for children with cancer. Cleveland Clinic Children’s pediatric oncology team is part of The Children’s Oncology Group, a national organization that has nearly 100 active clinical trials going at any given time, including clinical trials for germ cell tumors in children. If your child qualifies, a clinical trial gives them access to the latest therapies and treatments before they’re widely available.

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Virtual visits:

Your child may not always feel up to leaving the house for appointments. Our virtual visits give them (and you) the chance to meet one-on-one with their providers from home.

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National recognition:

Cleveland Clinic Children’s is a trusted healthcare leader. We’re recognized throughout the U.S. for our expertise and care.

Diagnosing Germ Cell Tumors at Cleveland Clinic Children’s

Germ cell tumors are rare and complicated, and we don’t know exactly what causes them to develop. That can be frustrating, especially when you’re trying to sort through a lot of information to understand your child’s unique condition.

Sometimes, germ cell tumors cause symptoms. If the tumor is in their ovary or testicle, your child may have pain in their pelvis, belly, back or groin. If the tumor is somewhere else in their body, they might have trouble breathing (lungs), weak legs (low back), trouble peeing and pooping (pelvis) or a swollen, painful belly.

Some germ cell tumors secrete hormones that can cause your child to go into early puberty. Children assigned female at birth (AFAB) might grow breasts, pubic hair and get their periods. Children assigned male at birth (AMAB) might grow breasts (gynecomastia).

The good news is that germ cell tumors usually respond well to treatment, so the earlier you can get in to see us, the better.

Types of germ cell tumors

There are many different types of germ cell tumors. Sometimes, they’re benign (noncancerous). Other times, they can be malignant (cancerous). Benign tumors can get bigger, but they don’t spread from where they started. Malignant tumors can spread.

The types of germ cell tumors include:

  • Teratomas contain tissue like teeth, hair, muscle and bone. They can be mature or immature. Mature teratomas (dermoid cysts) are usually benign and are the most common type of ovarian germ cell tumor. Immature teratomas are usually malignant and grow fast.
  • Yolk sac tumors (endodermal sinus tumors) are the most common germ cell tumor in children. They contain cells like those in a developing embryo. They’re cancerous and spread fast to lymph nodes and other organs.
  • Germinomas are cancerous and can develop in your child’s ovaries or testicles but are most common in the brain and spinal cord.
  • Embryonal cell carcinoma is rare and cancerous. It often develops with other tumor types in a mixed germ cell tumor.
  • Polyembryomas are rare and contain components that look like embryos. These fast-growing cancerous tumors are often mixed with other types of germ cell tumors.
  • Choriocarcinomas are also rare and cancerous tumors. They contain cells that form the placenta during pregnancy. They can develop in the ovaries or testicles but often happen in the uterus. They can spread to both the fetus and the parent.
  • Mixed germ cell tumors contain two or more types of cancerous germ cell tumors. They’re very common.

What to expect at your first visit

Your first visit with us is our chance to learn more about your child and what they’ve experienced. Your provider will start by asking a few questions, like:

  • Does your child have any symptoms?
  • When did you or your child first notice something was going on in their body?
  • If they have symptoms, how have they impacted your child’s daily life?

We’ll also ask about your child’s overall health and their medical history. Then, we’ll do a physical examination to look for germ cell tumor symptoms we can see or feel — like lumps and bumps on your child’s body. And we’ll order some tests to confirm a diagnosis.

Testing for germ cell tumors

We’ll do several kinds of tests, including:

  • Blood tests to check the amounts of enzymes, proteins or hormones in your child’s blood. High levels of human chorionic gonadotropin (HCG), alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH) could be a sign of a germ cell tumor.
  • CT scans and MRIs give us detailed pictures inside your child’s body and can show us where the tumor is.
  • PET scans can show us where the tumor is and if it’s spread.
  • Ultrasounds use sound waves to create pictures inside your child’s body. They can show if the tumor is solid or filled with fluid (a cyst).
  • A biopsy lets us take a sample of tissue for a pathologist to look at under a microscope. Studying tissue samples helps us find out the kind of tumor your child has. If they have a malignant germ cell tumor, a biopsy can show us if it’s spread. Other times, we’ll simply remove the tumor with surgery instead of taking the sample.

We understand that your child may feel anxious as they go through these important tests. So, we’ll take time to explain why we’re doing them and what’s involved. We want your child to be as comfortable as possible.

Second opinions for germ cell tumors

Germ cell tumors are rare, so working with pediatric providers who have experience treating them is important. And you want those providers to be compassionate and connect with your child so they feel safe. A second opinion can give you the confidence that your child is getting the best possible care.

We know you’re anxious to get your child started on the road to good health, so we always try to schedule your child’s appointment with us as soon as possible, either in-person or virtually. A virtual visit is an excellent option if it’s hard to get in to see your child’s providers in person or if you don’t live nearby.

Meet Our Germ Cell Tumor Team

When you choose Cleveland Clinic Children’s, you and your child will work with many specialists with a single focus — helping your child with effective compassionate treatment. Your child’s team could include:

Locations

We offer treatment for germ cell tumors at the following location in Northeast Ohio.

Treating Germ Cell Tumors at Cleveland Clinic Children’s

If tests confirm your child has a germ cell tumor, their treatment will depend on a few things:

  • What kind of germ cell tumor it is (if it’s cancerous or not).
  • How big the tumor is and if it’s spread (the stage).
  • Where the tumor is.

Surgery to remove the tumor and, sometimes, the affected organ is the main treatment for germ cell tumors. If the tumor is cancerous, your child might also have chemotherapy after surgery. Chemo uses drugs to destroy any remaining cancer cells or keep them from dividing. It can also be the main treatment if the tumor can’t be removed safely, or it’s spread to other parts of your child’s body.

For cancerous germ cell tumors, your child’s provider may also recommend radiation therapy, which sends high energy X-rays to the cancer cells to destroy them. For some kinds of germ cell tumors, radiation therapy is the best treatment.

If your child is scared to have surgery, our child life specialists can help. They’ll explain how to talk with your child or teen about an upcoming procedure. And they’ll show you how to support them emotionally throughout their treatment and recovery.

Fertility preservation

You may not be thinking about your child’s fertility right now, but it’s important to know that, sometimes, cancer treatments can affect their ability to have biological children in the future. Our providers will explain all the treatment risks and fertility preservation options with you, like storing (banking) sperm or eggs for later use.

Follow-Up Care

Our follow-up care starts with helping your child recover after surgery, but it doesn’t stop there. We’ll care for your child long after they’ve finished treatment. Your child will continue to visit their providers regularly to see how they’re doing and to check their overall health. We’ll also do tests to make sure a germ cell tumor hasn’t come back or there aren’t any signs of new health conditions that may develop after treatment.

Taking the Next Step

If your child has a germ cell tumor, you’ll want to work with pediatric healthcare providers who specialize in treating rare conditions. And you’ll want compassionate providers who understand how children and teens react to having a serious illness. You’ll find that combination of expertise and compassion at Cleveland Clinic Children’s. We’ll develop personalized care plans that also include support for your child and you as you manage their illness and any long-term challenges.

Getting an appointment with the germ cell tumor experts at Cleveland Clinic Children’s is easy. We’ll help you to get the care your child needs.

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Getting an appointment with the germ cell tumor experts at Cleveland Clinic Children’s is easy. We’ll help you to get the care your child needs.


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Survivorship

Learning your child has cancer can be stressful, shocking and challenging. From the moment you get the news, your child is a survivor. As you face the challenges that go along with their cancer treatment and recovery — physical and emotional — we’ll be right there with you. At Cleveland Clinic Children’s, survivorship care is one part of your child’s journey. Through our Childhood Cancer Survivorship Program, you’ll find support for any medical and emotional challenges that may happen in the years following cancer treatment.

We’re also there for you throughout this entire journey. We offer a wide range of services, resources, clinics and support groups to help with any physical, emotional, financial and spiritual needs you might have related to your child’s cancer diagnosis. Lending a helping hand along the way, we want your child not only survive, but thrive on this journey and beyond.

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