Questions About Cancer? 1-800-4-CANCER

Childhood Extracranial Germ Cell Tumors Treatment (PDQ®)

Patient Version
Last Modified: 02/08/2012

Treatment Options for Childhood Extracranial Germ Cell Tumors

Mature and Immature Teratomas
Malignant Gonadal Germ Cell Tumors
        Malignant Testicular Germ Cell Tumors
        Malignant Ovarian Germ Cell Tumors
Malignant Extragonadal Germ Cell Tumors
Recurrent Childhood Malignant Extracranial Germ Cell Tumors

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Mature and Immature Teratomas

Treatment of mature and immature teratomas in the sacrum or coccyx is usually surgery followed by watchful waiting. Most teratomas can be removed completely. If the tumor is in the coccyx, the entire coccyx is removed. Chemotherapy may be given if the tumor comes back.

Treatment of mature and immature teratomas that are not in the sacrum or coccyx is usually surgery followed by watchful waiting. A second surgery may be done to remove any remaining cancer.

Sometimes a mature or immature teratoma also has malignant cells. The teratoma and malignant cells may need to be treated differently. The best treatment for the malignant cells is not known.

Regular follow-up exams with imaging tests and the alpha-fetoprotein (AFP) tumor marker test will be done for at least 3 years.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood teratoma 1. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 2.

Malignant Gonadal Germ Cell Tumors

Malignant Testicular Germ Cell Tumors

Treatment of malignant testicular germ cell tumors may include the following:

For boys younger than 15 years:

For boys 15 years and older:

Malignant testicular germ cell tumors in boys 15 years and older are treated differently than they are in young boys. Surgery may include removal of lymph nodes in the abdomen. Treatment depends on whether the tumor is a seminoma or a nonseminoma. (See the PDQ summary on Testicular Cancer Treatment 3 for more information.)

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood malignant testicular germ cell tumor 4. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 2.

Malignant Ovarian Germ Cell Tumors

Treatment of childhood malignant ovarian germ cell tumors in young girls may include the following:

The treatment for adolescents and young adults with ovarian germ cell tumor is similar to the treatment for adults. (See the PDQ treatment summary on Ovarian Germ Cell Tumors 5 for more information.)

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood malignant ovarian germ cell tumor 6. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 2.

Malignant Extragonadal Germ Cell Tumors

Treatment of childhood extragonadal malignant germ cell tumors may include the following:

(See the PDQ treatment summary on Extragonadal Germ Cell Tumors 7 for more information.)

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood extragonadal germ cell tumor 8. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 2.

Recurrent Childhood Malignant Extracranial Germ Cell Tumors

There is no standard treatment for recurrent childhood malignant extracranial germ cell tumors. Treatment is usually within in a clinical trial and may include the following:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent childhood malignant germ cell tumor 9. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site 2.



Glossary Terms

abdomen (AB-doh-men)
The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
alpha-fetoprotein (AL-fuh-FEE-toh-PROH-teen)
A protein normally produced by a fetus. AFP levels are usually undetectable in the blood of healthy adult men or women (who are not pregnant). An elevated level of AFP suggests the presence of either a primary liver cancer or germ cell tumor. Also called AFP.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
clinical trial (KLIH-nih-kul TRY-ul)
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.
coccyx (KOK-six)
The small bone at the bottom of the spine. It is made up of 3-5 fused bones. Also called tailbone.
combination chemotherapy (KOM-bih-NAY-shun KEE-moh-THAYR-uh-pee)
Treatment using more than one anticancer drug.
dose (dose)
The amount of medicine taken, or radiation given, at one time.
dysgerminoma (DIS-jer-mih-NOH-muh)
A type of tumor that begins in the type of cells that give rise to egg cells and is most often found in the ovaries. Dysgerminomas may also occur in other places in the body, including the central nervous system. They are the most common type of ovarian germ cell tumor and can spread to other parts of the body. They are most common in females who are younger than 20 years old.
extracranial germ cell tumor (EK-struh-KRAY-nee-ul jerm sel TOO-mer)
A rare cancer that forms in germ cells in the testicle or ovary, or in germ cells that have traveled to areas of the body other than the brain (such as the chest, abdomen, or tailbone). Germ cells are reproductive cells that develop into sperm in males and eggs in females.
extragonadal germ cell tumor (EK-struh-goh-NA-dul jerm sel TOO-mer)
A rare cancer that develops in germ cells that are found in areas of the body other than the ovary or testicle (such as the brain, chest, abdomen, or tailbone). Germ cells are reproductive cells that develop into sperm in males and eggs in females.
follow-up (FAH-loh-up)
Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.
imaging test (IH-muh-jing …)
A type of test that makes pictures of areas inside the body. Some examples of imaging tests are CT scans and MRIs. Also called imaging procedure.
immature teratoma (IH-muh-CHOOR TAYR-uh-TOH-muh)
A rare type of germ cell tumor (type of tumor that begins in the cells that give rise to sperm or eggs). Immature teratomas often contain several different types of tissue such as hair, muscle, and bone.
inguinal orchiectomy (IN-gwih-nul OR-kee-EK-toh-mee)
An operation in which the testicle is removed through an incision in the groin.
lung (lung)
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
lymph node (limf node)
A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.
malignant (muh-LIG-nunt)
Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body.
mature teratoma (muh-CHOOR TAYR-uh-TOH-muh)
A type of benign (not cancer) germ cell tumor (type of tumor that begins in the cells that give rise to sperm or eggs) that often contains several different types of tissue such as hair, muscle, and bone. Also called dermoid cyst.
mediastinum (MEE-dee-uh-STY-num)
The area between the lungs. The organs in this area include the heart and its large blood vessels, the trachea, the esophagus, the thymus, and lymph nodes but not the lungs.
nonseminoma (NON-seh-mih-NOH-muh)
A type of cancer that begins in cells that form sperm or eggs. There are several types of nonseminoma tumors, including embryonal carcinoma, malignant teratoma, choriocarcinoma, and yolk sac tumor. These tumors are usually made up of more than one type of cancer cell. Although nonseminomas occur most often in the testicles or ovaries, they can occur in other tissues, such as the brain, chest, or abdomen. This happens when cells that have the ability to form sperm or eggs are found in other parts of the body.
ovarian germ cell tumor (oh-VAYR-ee-un jerm sel TOO-mer)
An abnormal mass of tissue that forms in germ (egg) cells in the ovary (female reproductive gland in which the eggs are formed). These tumors usually occur in teenage girls or young women, usually affect just one ovary, and can be benign (not cancer) or malignant (cancer). The most common ovarian germ cell tumor is called dysgerminoma.
PDQ
PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.
recur (ree-KER)
To come back or to return.
recurrent cancer (ree-KER-ent KAN-ser)
Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.
regimen (REH-jih-men)
A treatment plan that specifies the dosage, the schedule, and the duration of treatment.
sacrum (SAY-krum)
The large, triangle-shaped bone in the lower spine that forms part of the pelvis. It is made of 5 fused bones of the spine.
seminoma (SEH-mih-NOH-muh)
A type of cancer that begins in cells that make sperm or eggs. Seminomas occur most often in the testicles or the ovaries. They may also occur in other organs, such as the brain, chest, or abdomen. This happens when cells that have the ability to form sperm or eggs are found in other parts of the body. Seminomas grow and spread slowly.
stage (stayj)
The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
standard therapy (... THAYR-uh-pee)
Treatment that experts agree is appropriate, accepted, and widely used. Also called best practice, standard medical care, and standard of care.
surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
teratoma (TAYR-uh-TOH-muh)
A type of germ cell tumor that may contain several different types of tissue, such as hair, muscle, and bone. Teratomas occur most often in the ovaries in women, the testicles in men, and the tailbone in children. Not all teratomas are malignant.
testicular germ cell tumor (tes-TIH-kyuh-ler jerm sel TOO-mer)
A type of tumor that forms in a testicle from germ cells (cells that make sperm). Two main types of testicular germ cell tumors are seminomas and nonseminomas. Seminomas grow and spread slowly and are sensitive to radiation therapy. Nonseminomas grow and spread more quickly than seminomas. There are several different types of nonseminomas.
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
tumor debulking (TOO-mer dee-BUL-king)
Surgical removal of as much of a tumor as possible. Tumor debulking may increase the chance that chemotherapy or radiation therapy will kill all the tumor cells. It may also be done to relieve symptoms or help the patient live longer. Also called debulking.
tumor marker (TOO-mer MAR-ker)
A substance found in tissue, blood, or other body fluids that may be a sign of cancer or certain benign (noncancerous) conditions. Most tumor markers are made by both normal cells and cancer cells, but they are made in larger amounts by cancer cells. A tumor marker may help to diagnose cancer, plan treatment, or find out how well treatment is working or if cancer has come back. Examples of tumor markers include CA-125 (in ovarian cancer), CA 15-3 (in breast cancer), CEA (in colon cancer), and PSA (in prostate cancer).
unilateral salpingo-oophorectomy (YOO-nih-LA-teh-rul sal-PIN-goh-oh-oh-foh-REK-toh-mee)
Surgery to remove the ovary and fallopian tube on one side of the body.
watchful waiting (WACH-ful WAY-ting)
Closely watching a patient’s condition but not giving treatment unless symptoms appear or change. Watchful waiting is sometimes used in conditions that progress slowly. It is also used when the risks of treatment are greater than the possible benefits. During watchful waiting, patients may be given certain tests and exams. Watchful waiting is sometimes used in prostate cancer. It is a type of expectant management.

Table of Links

1http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=43494&tt=1&a
mp;format=1&cn=1
2http://www.cancer.gov/clinicaltrials
3http://www.cancer.gov/cancertopics/pdq/treatment/testicular/Patient
4http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=43495&tt=1&a
mp;format=1&cn=1
5http://www.cancer.gov/cancertopics/pdq/treatment/ovarian-germ-cell/Patient
6http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=43496&tt=1&a
mp;format=1&cn=1
7http://www.cancer.gov/cancertopics/pdq/treatment/extragonadal-germ-cell/Patient
8http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=43497&tt=1&a
mp;format=1&cn=1
9http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=43498&tt=1&a
mp;format=1&cn=1