'Copy and Pasted' below is more information about germ cell tumours and teratomas.
• Ovarian teratoma: Mature cystic teratomas of the ovary are often discovered as incidental findings on physical examination, during radiographic studies, or during abdominal surgery performed for other indications. When symptoms are present, they may include abdominal pain, mass or swelling, and abnormal uterine bleeding. Bladder symptoms, gastrointestinal disturbances, and back pain are less frequent. When abdominal pain is present, it usually is constant and ranges from slight to moderate in intensity. Torsion and acute rupture commonly are associated with severe pain.
• Testicular teratomas most often present as a painless scrotal mass, except in the case of torsion. In most cases, the masses are firm or hard, nontender, and do not transilluminate. Testicular pain and scrotal swelling are occasionally reported with teratomas, but this is nonspecific and simply indicates torsion until proven otherwise. On examination, the testis is diffusely enlarged, rather than nodular.
What are germ cell tumors?
Germ cell tumors are malignant (cancerous) or nonmalignant (benign, noncancerous) tumors that are comprised mostly of germ cells. Germ cells are the cells that develop in the embryo (fetus, or unborn baby) and become the cells that make up the reproductive system in males and females. These germ cells follow a midline path through the body after development and descend into the pelvis as ovarian cells or into the scrotal sac as testicular cells. Most ovarian tumors and testicular tumors are of germ cell origin. The ovaries and testes are called gonads.
Tumor sites outside the gonad are called extragonadal sites. The tumors also occur along the midline path and can be found in the head, chest, abdomen, pelvis, and sacrococcygeal (lower back) area.
Germ cell tumors are rare. Germ cell tumors account for about 2 to 4 percent of all cancers in children and adolescents younger than age 20.
Germ cell tumors can spread (metastasize) to other parts of the body. The most common sites for metastasis are the lungs, liver, lymph nodes, and central nervous system. Rarely, germ cell tumors can spread to the bone, bone marrow, and other organs.
What causes germ cell tumors?
The cause of germ cell tumors isn't completely understood. A number of inherited defects have also been associated with an increased risk for developing germ cell tumors including the central nervous system and genitourinary tract malformations and major malformations of the lower spine. Specifically, males with cryptorchidism (failure of the testes to descend into the scrotal sac) have an increased risk to develop testicular germ cell tumors. Cryptorchidism can occur alone, however, and is also present in some genetic syndromes.
Some genetic syndromes caused by extra or missing sex chromosomes can cause incomplete or abnormal development of the reproductive system.
What are the symptoms of germ cell tumors?
The following are the most common symptoms of germ cell tumors. However, each child may experience symptoms differently. Symptoms vary depending on the size and location of the tumor.
Symptoms may include:
• A tumor, swelling, or mass that can be felt or seen
• Elevated levels of alpha-fetoprotein (AFP)
• Elevated levels of beta-human chorionic gonadotropin (ß-HCG)
• Constipation, incontinence, and leg weakness can occur if the tumor is in the sacrum (a segment of the vertebral column that forms the top part of the pelvis) compressing structures
• Abdominal pain
• Abnormal shape, or irregularity in, testicular size
• Shortness of breath or wheezing if tumors in the chest are pressing on the lungs.
The symptoms of germ cell tumors may resemble other conditions or medical problems. Always consult your child's doctor for a diagnosis.