Introduction

Germ cells are the cells of the embryo normally developed to produce sperm or ova. These cells may form tumours. Depending on the histological features, they are divided into different types. They can be benign or malignant.

Germ cell tumours are rare, but they can occur in all age groups. The common sites of the tumour are the testes, the ovaries, the sacrococcygeal region (near the bottom of the spine), in the middle of the brain, chest or abdomen.

Symptoms

Usually, a lump is seen or felt. The symptoms are highly variable, depending on the site of occurrence. For example, they can be present as a mass in the abdomen, buttock mass, or they can cause urinary obstruction, testicular swelling, and pain.

Diagnostic Tests

Usually, a biopsy of the tumour is done. Blood is taken to test the levels of alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) which are produced by some types of germ cell tumours. A chest X-ray, computerised tomography (CT) scan, bone scan and a bone marrow aspiration are also used to assess the spread of the tumour.

Treatment

If possible, the tumour should be removed by surgery. This may completely cure benign tumours and some malignant tumours, and stop the disease from spreading. Sometimes, it may involve removing the entire ovary or testicle. If the malignant tumour has spread, surgery is usually followed by chemotherapy lasting 6 to 12 months. For some children, radiotherapy is also necessary.

Long-term Care

As some germ cell tumours secrete AFP and HCG, measurement of these levels in blood helps to monitor the progress of such tumours during treatment and follow-up. A high level means that the tumour has not been cured or it has recurred. Regular chest X-ray, CT scan and ultrasound examinations maybe necessary to detect any recurrence. The success of treatment depends on various factors, including the type and site of the tumour, and whether the cells of the tumour have spread.