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Extragonadal Germ Cell Tumors Treatment (PDQ®)

Patient Version
Last Modified: 06/13/2008

General Information About Extragonadal Germ Cell Tumors

Key Points for This Section


Extragonadal germ cell tumors form from developing sperm or egg cells that travel from the gonads to other parts of the body.

“Extragonadal” means outside of the gonads (sex organs). When cells that are meant to form sperm in the testicles or eggs in the ovaries travel to other parts of the body, they may grow into extragonadal germ cell tumors. These tumors may begin to grow anywhere in the body but usually begin in organs such as the pineal gland in the brain, in the mediastinum, or in the abdomen.

Extragonadal germ cell tumors can be benign (noncancer) or malignant (cancer). Benign extragonadal germ cell tumors are called benign teratomas. These are more common than malignant extragonadal germ cell tumors and often are very large.

Malignant extragonadal germ cell tumors are divided into two types, nonseminoma and seminoma. Nonseminomas tend to grow and spread more quickly than seminomas. They usually are large and cause symptoms. If untreated, malignant extragonadal germ cell tumors may spread to the lungs, lymph nodes, bones, liver, or other parts of the body.

For information about germ cell tumors in the ovaries and testicles, see the following PDQ summaries:

Age and gender can affect the risk of developing extragonadal germ cell tumors.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for malignant extragonadal germ cell tumors include the following:

Possible signs of extragonadal germ cell tumors include chest pain and breathing problems.

Malignant extragonadal germ cell tumors may cause symptoms as they grow into nearby areas. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

  • Chest pain.
  • Breathing problems.
  • Cough.
  • Fever.
  • Headache.
  • Change in bowel habits.
  • Feeling very tired.
  • Trouble walking.
  • Trouble in seeing or moving the eyes.

Imaging and blood tests are used to detect (find) and diagnose extragonadal germ cell tumors.

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The testicles may be checked for lumps, swelling, or pain. A history of the patient's health habits and past illnesses and treatments will also be taken.

  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

  • Serum tumor marker test: A procedure in which a sample of blood is examined to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The following three tumor markers are used to detect extragonadal germ cell tumor: Blood levels of the tumor markers help determine if the tumor is a seminoma or nonseminoma.

  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

  • Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as the testicles, and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.

  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The type of biopsy used depends on where the extragonadal germ cell tumor is found.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

  • Whether the tumor is nonseminoma or seminoma.
  • The size of the tumor and where it is in the body.
  • The blood levels of AFP, β-hCG, and LDH.
  • Whether the tumor has spread to other parts of the body.
  • The way the tumor responds to initial treatment.
  • Whether the tumor has just been diagnosed or has recurred (come back).

Stages of Extragonadal Germ Cell Tumors

Key Points for This Section


After an extragonadal germ cell tumor has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.

The extent or spread of cancer is usually described as stages. For extragonadal germ cell tumors, prognostic groups are used instead of stages. The tumors are grouped according to how well the cancer is expected to respond to treatment. It is important to know the prognostic group in order to plan treatment.

There are three ways that cancer spreads in the body.

The three ways that cancer spreads in the body are:

  • Through tissue. Cancer invades the surrounding normal tissue.
  • Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
  • Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

The following prognostic groups are used for extragonadal germ cell tumors:

Good prognosis

A nonseminoma extragonadal germ cell tumor is in the good prognosis group if:

A seminoma extragonadal germ cell tumor is in the good prognosis group if:

Intermediate prognosis

A nonseminoma extragonadal germ cell tumor is in the intermediate prognosis group if:

A seminoma extragonadal germ cell tumor is in the intermediate prognosis group if:

Poor prognosis

A nonseminoma extragonadal germ cell tumor is in the poor prognosis group if:

Seminoma extragonadal germ cell tumor does not have a poor prognosis group.

Treatment Option Overview

Key Points for This Section


There are different types of treatment for patients with extragonadal germ cell tumors.

Different types of treatments are available for patients with extragonadal germ cell tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Three types of standard treatment are used:

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Surgery

Patients who have benign tumors or tumor remaining after chemotherapy or radiation therapy may need to have surgery.

New types of treatment are being tested in clinical trials.

This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site 3.

High-dose chemotherapy with stem cell transplant

High-dose chemotherapy with stem cell transplant is a method of giving high doses of chemotherapy and replacing blood -forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

After initial treatment for extragonadal germ cell tumors, blood levels of AFP and other tumor markers continue to be checked to find out how well the treatment is working.

Treatment Options for Extragonadal 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.

Benign Teratoma

Treatment of benign teratomas is surgery.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with benign teratoma 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 5.

Seminoma

Treatment of seminoma extragonadal germ cell tumors may include the following:

  • Radiation therapy for small tumors in one area, followed by watchful waiting if there is tumor remaining after treatment.
  • Chemotherapy for larger tumors or tumors that have spread. If a tumor smaller than 3 centimeters remains after chemotherapy, watchful waiting follows. If a larger tumor remains after treatment, surgery or watchful waiting follow.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with extragonadal seminoma 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 5.

Nonseminoma

Treatment of nonseminoma extragonadal germ cell tumors may include the following:

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with malignant extragonadal non-seminomatous germ cell tumor 7. 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 5.

Recurrent or Refractory Extragonadal Germ Cell Tumors

Treatment of extragonadal germ cell tumors that are recurrent (come back after being treated) or refractory (do not get better during treatment) 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 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 5.

Changes to This Summary (06/13/2008)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Several enhancements have been made to this summary to better explain certain medical concepts and to help readers find information about clinical trials. The following changes were made:

  • Text describing the way cancer spreads in the body was added to the Stages 19 section.
  • Information about patients taking part in clinical trials and about follow-up tests was added to the Treatment Option Overview 20 section.
  • Links to ongoing clinical trials listed in NCI’s PDQ Cancer Clinical Trials Registry were added to the Treatment Options 21 section.
  • A new section called “To Learn More 22” was added. It includes links to more information about this type of cancer and about cancer in general.
  • The “Get More Information from NCI” section (originally called “To Learn More”) was revised.

Get More Information From NCI

Call 1-800-4-CANCER

For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.

Chat online

The NCI's LiveHelp® 23 online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Write to us

For more information from the NCI, please write to this address:

NCI Public Inquiries Office
Suite 3036A
6116 Executive Boulevard, MSC8322
Bethesda, MD 20892-8322

Search the NCI Web site

The NCI Web site 24 provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each Web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen Web pages that are most closely related to the search term entered.

There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.

Find Publications

The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator 25. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site 24. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site 5. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).



Glossary Terms

abdomen (AB-doh-men)
The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
AFP
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 alpha-fetoprotein.
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.
benign (beh-NINE)
Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body. Also called nonmalignant.
beta-human chorionic gonadotropin (BAY-tuh-HYOO-mun KOR-ee-AH-nik goh-NA-doh-TROH-pin)
A hormone found in the blood and urine during pregnancy. It may also be found in higher than normal amounts in patients with some types of cancer, including testicular, ovarian, liver, stomach, and lung cancers, and in other disorders. Measuring the amount of beta-human chorionic gonadotropin in the blood or urine of cancer patients may help to diagnose cancer and find out how well cancer treatment is working. Beta-human chorionic gonadotropin is a type of tumor marker. Also called beta-hCG.
biopsy (BY-op-see)
The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
bowel (BOW-ul)
The long, tube-shaped organ in the abdomen that completes the process of digestion. The bowel has two parts, the small bowel and the large bowel. Also called intestine.
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.
chest x-ray (chest EX-ray)
An x-ray of the structures inside the chest. An x-ray is a type of high-energy radiation that can go through the body and onto film, making pictures of areas inside the chest, which can be used to diagnose disease.
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.
contrast material (KON-trast muh-TEER-ee-ul)
A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.
core biopsy (... BY-op-see)
The removal of a tissue sample with a wide needle for examination under a microscope. Also called core needle biopsy.
CT scan (… skan)
A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.
diagnosis (DY-ug-NOH-sis)
The process of identifying a disease, such as cancer, from its signs and symptoms.
excisional biopsy (ek-SIH-zhuh-nul BY-op-see)
A surgical procedure in which an entire lump or suspicious area is removed for diagnosis. The tissue is then examined under a microscope.
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.
fever (FEE-ver)
An increase in body temperature above normal (98.6 degrees F), usually caused by disease.
fine-needle aspiration biopsy (... NEE-dul AS-pih-RAY-shun BY-op-see)
The removal of tissue or fluid with a thin needle for examination under a microscope. Also called FNA biopsy.
fluid (FLOO-id)
A substance that flows smoothly and takes the shape of its container. Liquids and gases are fluids.
germ cell tumor (jerm sel TOO-mer)
A type of tumor that begins in the cells that give rise to sperm or eggs. Germ cell tumors can occur almost anywhere in the body and can be either benign or malignant.
gonad (GOH-nad)
The part of the reproductive system that produces and releases eggs (ovary) or sperm (testicle/testis).
incisional biopsy (in-SIH-zhuh-nul BY-op-see)
A surgical procedure in which a portion of a lump or suspicious area is removed for diagnosis. The tissue is then examined under a microscope to check for signs of disease.
injection (in-JEK-shun)
Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."
Klinefelter syndrome (KLINE-fel-ter SIN-drome)
A genetic disorder in males caused by having one or more extra X chromosomes. Males with this disorder may have larger than normal breasts, a lack of facial and body hair, a rounded body type, and small testicles. They may learn to speak much later than other children and may have difficulty learning to read and write. Klinefelter syndrome increases the risk of developing extragonadal germ cell tumors and breast cancer.
lactate dehydrogenase (LAK-tayt dee-hy-DRAH-jeh-nays)
One of a group of enzymes found in the blood and other body tissues and involved in energy production in cells. An increased amount of lactate dehydrogenase in the blood may be a sign of tissue damage and some types of cancer or other diseases. Also called lactic acid dehydrogenase and LDH.
LDH
One of a group of enzymes found in the blood and other body tissues, and involved in energy production in cells. An increased amount in the blood may be a sign of tissue damage and some types of cancer or other diseases. Also called lactate dehydrogenase and lactic acid dehydrogenase.
liver (LIH-ver)
A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.
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.
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.
organ (OR-gun)
A part of the body that performs a specific function. For example, the heart is an organ.
ovary (OH-vuh-ree)
One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.
pathologist (puh-THAH-loh-jist)
A doctor who identifies diseases by studying cells and tissues under a microscope.
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.
physical examination (FIH-zih-kul eg-ZA-mih-NAY-shun)
An exam of the body to check for general signs of disease.
pineal gland (PIH-nee-ul ...)
A tiny organ in the cerebrum that produces melatonin. Also called pineal body and pineal organ.
prognosis (prog-NO-sis)
The likely outcome or course of a disease; the chance of recovery or recurrence.
recur (ree-KER)
To come back or to return.
risk factor (... FAK-ter)
Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.
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.
serum tumor marker test (SEER-um TOO-mer MAR-ker ...)
A blood test that measures the amount of substances called tumor markers (or biomarkers). Tumor markers are released into the blood by tumor cells or by other cells in response to tumor cells. A high level of a tumor marker may be a sign of cancer.
sonogram (SAH-noh-gram)
A computer picture of areas inside the body created by bouncing high-energy sound waves (ultrasound) off internal tissues or organs. Also called ultrasonogram.
sperm (spurm)
The male reproductive cell, formed in the testicle. A sperm unites with an egg to form an embryo.
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.
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
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.
testicle (TES-tih-kul)
One of two egg-shaped glands inside the scrotum that produce sperm and male hormones. Also called testis.
tissue (TIH-shoo)
A group or layer of cells that work together to perform a specific function.
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 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).
ultrasound (UL-truh-SOWND)
A procedure in which high-energy sound waves are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.
vein (vayn)
A blood vessel that carries blood to the heart from tissues and organs in the body.
x-ray (EX-ray)
A type of radiation used in the diagnosis and treatment of cancer and other diseases. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.

Table of Links

1http://www.cancer.gov/cancertopics/pdq/treatment/ovarian-germ-cell/Patient
2http://www.cancer.gov/cancertopics/pdq/treatment/testicular/Patient
3http://cancer.gov/clinicaltrials
4http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=561977&tt=1&
amp;format=1&cn=1
5http://www.cancer.gov/clinicaltrials
6http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=561988&tt=1&
amp;format=1&cn=1
7http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=561980&tt=1&
amp;format=1&cn=1
8http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?Diagnosis=562066&tt=1&
amp;format=1&cn=1
9http://www.cancer.gov/cancertopics/types/extragonadal-germ-cell
10http://www.cancer.gov/cancertopics/wyntk/overview
11http://www.cancer.gov/cancertopics/understandingcancer/cancer
12http://www.cancer.gov/cancertopics/factsheet/Detection/staging
13http://www.cancer.gov/cancertopics/chemotherapy-and-you
14http://www.cancer.gov/cancertopics/radiation-therapy-and-you
15http://www.cancer.gov/cancertopics/coping
16http://www.cancer.gov/cancertopics/cancerlibrary/questions
17http://www.cancer.gov/cancertopics/cancerlibrary
18http://dccps.cancer.gov/ocs/resources.html
19http://www.cancer.gov/cancertopics/pdq/treatment/extragonadal-germ-cell/Patient
/Page2#Section_107
20http://www.cancer.gov/cancertopics/pdq/treatment/extragonadal-germ-cell/Patient
/Page3#Section_43
21http://www.cancer.gov/cancertopics/pdq/treatment/extragonadal-germ-cell/Patient
/Page4#Section_140
22http://www.cancer.gov/cancertopics/pdq/treatment/extragonadal-germ-cell/Patient
/Page5#Section_167
23https://livehelp.cancer.gov
24http://cancer.gov
25https://pubs.cancer.gov/ncipl