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Childhood Germ Cell Tumor Diagnosis

Most germ cell tumors are identified as a lump in the testicles or elsewhere along the midline of the body. Upon discovery of the lump, often the physician will arrange for a biopsy of the tumor.

Since germ cell tumors are unique among solid tumors in that they secrete serum tumor markers, blood tests for elevated levels of alpha feto-protein, human chorionic gonadotropin and lactate dehydrogenase are useful in diagnosis as well as in monitoring the tumor’s response to therapy.

Imaging studies, such as CT scan, MRI, X-ray, ultrasound and bone scans are also performed, depending upon the tumor’s location.

If your child has been diagnosed with a germ cell tumor, we’re here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.

Childhood Germ Cell Tumor Staging

(source: National Cancer Institute)

The process used to find out if cancer has spread from where the tumor started to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. In some cases, staging may follow surgery to remove the tumor. There are different staging systems, depending on the type of germ cell tumor.

Childhood Nonseminoma Testicular Germ Cell Tumor Staging

Stage I: The cancer is found only in the testicle and is completely removed by surgery. Tumor marker levels return to normal after surgery.

Stage II: The cancer is removed by surgery and some cancer cells remain in the scrotum or cancer that can only be seen with a microscope has spread to the scrotum or spermatic cord. Tumor marker levels do not return to normal after surgery and may increase.

Stage III: The cancer has spread to one or more lymph nodes in the abdomen and is not completely removed by surgery. The cancer that remains after surgery can be seen without a microscope.

Stage IV: The cancer has spread to distant parts of the body such as the liver.

Childhood Ovarian Germ Cell Tumor Staging

Stage I: Cancer is found in one or both of the ovaries and has not spread. Stage I is divided into stage IA, stage IB, and stage IC: 

  • Stage IA: Cancer is found in a single ovary.
  • Stage IB: Cancer is found in both ovaries.
  • Stage IC: Cancer is found in one or both ovaries and one of the following is true:
    • cancer is found on the outside surface of one or both ovaries; or
    • the capsule (outer covering) of the tumor has ruptured (broken open); or
    • cancer cells are found in fluid that has collected in the abdomen; or
    • cancer cells are found in washings of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen).

Stage II: Cancer is found in one or both ovaries and has spread into other areas of the pelvis. Stage II is divided into stage IIA, stage IIB, and stage IIC: 

  • Stage IIA: Cancer has spread to the uterus and/or the fallopian tubes (the long slender tubes through which eggs pass from the ovaries to the uterus).
  • Stage IIB: Cancer has spread to other tissue within the pelvis such as the bladder, rectum, or vagina.
  • Stage IIC: Cancer has spread to the uterus and/or fallopian tubes and/or other tissue within the pelvis and one of the following is true:
    • cancer is found on the outside surface of one or both ovaries; or
    • the capsule (outer covering) of the tumor has ruptured (broken open); or
    • cancer cells are found in fluid that has collected in the abdomen; or
    • cancer cells are found in washings of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen).

Stage III: Cancer is found in one or both ovaries and has spread to other parts of the abdomen. Stage III is divided into stage IIIA, stage IIIB, and stage IIIC as follows:

  • Stage IIIA: The tumor is found only in the pelvis, but cancer cells that only can be seen with a microscope have spread to the surface of the peritoneum (tissue that lines the abdominal wall and covers most of the organs in the abdomen) or to the small bowel.
  • Stage IIIB: Cancer has spread to the peritoneum but is 2 centimeters or smaller in diameter.
  • Stage IIIC: Cancer has spread to the peritoneum and is larger than 2 centimeters in diameter and/or has spread to lymph nodes in the abdomen.

Cancer that has spread to the surface of the liver is also considered stage III disease.

Stage IV: Cancer is found in one or both ovaries and has metastasized (spread) beyond the abdomen to other parts of the body. Cancer that has spread to tissues in the liver is also considered stage IV disease.

Extragonadal Germ Cell Tumor Staging

Stage I: The cancer is in one place and can be completely removed by surgery. For tumors at the base of the tailbone, the cancer and tailbone are completed removed by surgery. Tumor marker levels return to normal after surgery.

Stage II: The cancer has spread to nearby tissues and/or lymph nodes and is not completely removed by surgery. The cancer remaining after surgery can be seen with a microscope only. Tumor marker levels do not return to normal after surgery and may increase.

Stage III: The cancer:

  • is not completely removed by surgery. The cancer remaining after surgery can be seen without a microscope; or
  • has spread to lymph nodes and is larger than 2 centimeters in diameter; or
  • is found in fluid in the abdomen.

Stage IV: The cancer has spread to distant parts of the body, including the liver.

If your child has been diagnosed with a germ cell tumor, we’re here to help. Call 1-877-632-6789 to make an appointment or request an appointment online.

Why Choose MD Anderson?

  • The Children’s Cancer Hospital is within one of the top-ranked cancer centers in America
  • Access to novel therapies and state-of-the-art technologies before most children’s hospitals
  • We see more types of cancer than any other children’s hospital in Texas
  • Family-centered care that actively involves parents in their child’s treatment
  • A strong cancer research program focused on developing new therapies for pediatric patients
  • Comprehensive support services such as an accredited school program, creative arts, child life and career counseling
  • An Adolescent and Young Adult Program that specializes in the unique medical and psychological needs of patients aged 15-25

Childhood Germ Cell Tumors Knowledge Center

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