Germ cell tumor (patient information)

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 * Associate Editor-In-Chief: Jinhui Wu, M.D.

Overview
Germ cells are special cells in a developing embryo that become the gonads in people. When these cells travel to other areas of the body such as the chest, abdomen, or brain, germ cell tumor appears. Germ cell tumor includes a large group of tumor such as germinoma, embryonal carcinoma, choriocarcinoma, teratoma and gonadoblastoma, etc. It can be benign or cancerous. Patients may not feel any discomfort at early peroid. With the development of the cancer, frequent symptoms include pain in the affected area, constipation, urinary retention, cough and/or difficulty breathing, headache, vaginal bleeding, etc. Treatments include surgery and chemotherapy.

What are the symptoms of Germ cell tumor?
The symptoms of germ cell tumor depend on the location of the cancer. Early cancer does not have any symptoms. As the tumor grows larger, patients may feel the following symptoms.


 * Pain in the affected area


 * Constipation


 * Urinary retention


 * Cough and/or difficulty breathing


 * Headache


 * Vaginal bleeding

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Who is at highest risk?
At present, the risk factors for the development of a germ cell tumor are not known.

When to seek urgent medical care?
Call your health care provider if symptoms of germ cell tumor develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:


 * Severe pain


 * Severe constipation


 * Urinary retention


 * Severe difficulty breathing


 * Severe headache


 * Large vaginal bleeding

Diagnosis

 * Biopsy: Biopsy is the most important test for the diagnosis. During this peroid, the doctors remove a small amount of tissue for examination under a microscope. Then the pathologists may analyze the samples and tell whether the tissues is benign or cancerous.


 * Alphafetoprotein (AFP) test: AFP is a tumor marker for a germ cell tumor. It is a protein that increases in the mother’s blood during pregnancy and can be detected by amniocentesis. Beside, the levels of AFP in the blood may be monitored to determine how well a treatment is working.


 * Ultrasonography: This is an painless test which uses sound waves to create a picture of the internal organs. Because tumors generate different echoes of sound waves than normal tissue, the doctor can locate a mass inside the body.


 * Computed tomography (CT) scan and biopsy: CT scans are often used to diagnose germ cell tumor. It can confirm the location of the cancer and show the organs nearby. These are helpful for determining the stage of the cancer and in determining whether surgery is a good treatment option. CT scans can also be used to guide biopsy and a biopsy sample is usually removed and looked at under a microscope.
 * Magnetic resonance imaging (MRI): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture.


 * Positron emission tomography (PET) scan: When doing this test, a small amount of a radioactive medium is injected into your body and absorbed by the organs or tissues. This radioactive substance gives off energy which in turn is used to produce the images. PET can provide more helpful information than either CT or MRI scans. It is useful to see if the cancer has spread to the lymph nodes and it is also useful for your doctor to locate where the cancer has spread.

Treatment options
The treatment slection of a germ cell tumor depends on the size and location of the tumor, whether it is cancerous, whether the cancer has spread, and the patient’s overall health. The options are surgery and chemotherapy, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.


 * Surgery: The goal of surgery is to remove the tumor and some surrounding tissue to make sure that the entire tumor is removed.


 * Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.Chemotherapy is the use of drugs to kill cancer cells. The usual drugs for germ cell tumors include cisplatin (Platinol), etoposide (VePesid, Etopophos, Toposar), bleomycin (Blenoxane), and cyclophosphamide (Cytoxan, Neosar).

Diseases with similar symptoms

 * Organ inflammation


 * Organ parasitic infection


 * Organ other kind of tumor

Where to find medical care for Germ cell tumor?
Directions to Hospitals Treating Germ cell tumor

What to expect (Outlook/Prognosis)?
The prognosis of germ cell tumor depends on the following:


 * Whether the tumor is benign or cancerous


 * Whether or not the tumor can be removed by surgery


 * The stage of the cancer: the size and location of the tumor, whether the cancer has spread outside the tumor


 * Whether the cancer has just been diagnosed or has recurred


 * The patient’s general health

Prevention
For the risk factors are not clear, the preventive measure is unknown.