Extragonadal Germ Cell Tumors
What are extragonadal germ cell tumors?
This summary discusses the treatment of extragonadal germ cell tumors.
Germ cell tumors develop from testicular or ovarian cells. Sometimes these cells travel to the chest or abdomen and may turn into a rare type of cancer called extragonadal germ cell tumor.
Extragonadal germ cell tumors can be cancerous or noncancerous. The cancerous tumors are divided into 2 types, seminoma and nonseminoma. Nonseminoma cancers include embryonal carcinoma, malignant teratoma, endodermal sinus tumor, choriocarcinoma, and mixed germ cell tumors. These tumors are more common in males, but also occur in females; they are aggressive tumors and are usually found in young adults. Nonseminomas can develop anywhere, but usually appear in the chest, abdomen, or brain. Diagnosing (finding) the tumor may be difficult; in young people who have masses in the trunk of the body, nonseminoma should be considered.
Noncancerous extragonadal germ cell tumors are often very large. They are treated with surgery (taking out the cancer).
Seminomas are very sensitive to radiation therapy (using x-rays to kill cancer cells). About 60% to 80% of patients who undergo radiation therapy will stay disease-free. Chemotherapy (using drugs to kill cancer cells) is also very effective for seminoma. Patients who have localized (cancer that is still in the organ where the cancer began) small tumors are usually treated first with radiation therapy. Patients who have large tumors, or tumors that are spreading, are treated with chemotherapy that consists of etoposide- and cisplatin-based anticancer drugs. Many patients will still have some tumor left after treatment. Small masses will be closely monitored, but will not be treated until symptoms appear or change. Larger masses may be monitored and/or removed with surgery.
Patients who have nonseminomas will receive chemotherapy when the cancer is diagnosed. Patients with nonseminomas usually have large tumors and have symptoms. Early surgery for nonseminoma is seldom useful, and patients may be treated in a clinical trial. Patients who have tumor remaining after chemotherapy may undergo surgery. Patients with nonseminomatous extragonadal germ cell tumors whose tumor comes back after chemotherapy may be treated on a clinical trial.
Nonseminomas that occur in the chest are more frequent in patients who have Klinefelter’s syndrome. These patients are at risk of also developing cancer of the blood. Treatment is more successful for patients who have small tumors that are not resistant to chemotherapy, and who are not likely to develop other cancers.
Patients with nonseminoma that occurs near the kidneys generally respond well to treatment, depending on the size of the tumor.
Changes to This Summary (06/03/2003)
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.
Editorial changes were made to this summary.
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