Treatment Options for Childhood Extracranial Germ Cell Tumors

Mature and Immature Teratomas
Malignant Gonadal Germ Cell Tumors
        Malignant Testicular Germ Cell Tumors
        Malignant Ovarian Germ Cell Tumors
Malignant Extragonadal Germ Cell Tumors
Recurrent Childhood Malignant Extracranial Germ Cell Tumors

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your child's doctor for clinical trials that are not listed here but may be right for your child.

Treatment of mature and immature teratomas in the sacrum or coccyx is usually surgery followed by watchful waiting. Most teratomas can be removed completely. If the tumor is in the coccyx, the entire coccyx is removed. Chemotherapy may be given if the tumor comes back.

Treatment of mature and immature teratomas that are not in the sacrum or coccyx is usually surgery followed by watchful waiting. A second surgery may be done to remove any remaining cancer.

Sometimes a mature or immature teratoma also has malignant cells. The teratoma and malignant cells may need to be treated differently. The best treatment for the malignant cells is not known.

Regular follow-up exams with imaging tests and the alpha-fetoprotein (AFP) tumor marker test will be done for at least 3 years.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood teratoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment of malignant testicular germ cell tumors may include the following:

For boys younger than 15 years:

• Surgery (radical inguinal orchiectomy) followed by watchful waiting for stage I tumors. Chemotherapy may be given if the tumor comes back.
• Surgery (radical inguinal orchiectomy) followed by combination chemotherapy for stage II-IV tumors.
• A clinical trial of fewer cycles of chemotherapy after surgery.

For boys 15 years and older:

Malignant testicular germ cell tumors in boys 15 years and older are treated differently than they are in young boys. Surgery may include removal of lymph nodes in the abdomen. Treatment depends on whether the tumor is a seminoma or a nonseminoma. (See the PDQ summary on Testicular Cancer Treatment for more information.)

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood malignant testicular germ cell tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment of childhood malignant ovarian germ cell tumors in young girls may include the following:

• Surgery (unilateral salpingo-oophorectomy) followed by watchful waiting for stage I dysgerminoma or immature teratoma tumors. Chemotherapy may be given if the tumor comes back.
• Surgery (unilateral salpingo-oophorectomy) followed by combination chemotherapy for stages II-IV tumors.
• Chemotherapy to make the tumor smaller, followed by surgery (unilateral salpingo-oophorectomy).
• Surgery (tumor debulking) followed by chemotherapy.
• A clinical trial of fewer cycles of chemotherapy after surgery.
• A clinical trial of surgery (unilateral salpingo-oophorectomy) followed by watchful waiting for stage I tumors that are not a dysgerminoma or immature teratoma.

The treatment for adolescents and young adults with ovarian germ cell tumor is similar to the treatment for adults. (See the PDQ treatment summary on Ovarian Germ Cell Tumors for more information.)

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood malignant ovarian germ cell tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment of childhood extragonadal malignant germ cell tumors may include the following:

• Surgery to remove tumors in the mediastinum (the area between the lungs).
• Surgery followed by combination chemotherapy.
• Combination chemotherapy followed by surgery.
• Chemotherapy only.
• A clinical trial of a new chemotherapy regimen.

(See the PDQ treatment summary on Extragonadal Germ Cell Tumors for more information.)

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood extragonadal germ cell tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

There is no standard treatment for recurrent childhood malignant extracranial germ cell tumors. Treatment is usually within in a clinical trial and may include the following:

• Surgery followed by combination chemotherapy, for malignant testicular germ cell tumors that recur after being treated with surgery and watchful waiting.
• Surgery for tumors that come back in the sacrum or coccyx. Chemotherapy may be given before surgery, to shrink the tumor. If any of the tumor remains after surgery, radiation therapy may be added.
• Surgery followed by chemotherapy, for malignant ovarian germ cell tumors that recur after being treated with surgery and watchful waiting.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent childhood malignant germ cell tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.