Non-Germinomatous Germ Cell Tumor

What is a non-germinomatous germ cell tumor?

Germ cell brain tumors develop from germ cells, which become sperm or eggs. During the fetal period, these cells may get trapped in the brain, causing a tumor.

Non-germinomatous germ cell tumors are also called “secreting tumors” because they may secrete alpha-fetoprotein (a protein produced during pregnancy) or a hormone called human chorionic gonadotropin (hCG). The secretion of these chemicals into the spinal fluid and bloodstream requires a more intensive treatment plan than pure germ cell tumors.

Germ cell tumors make up about 3% of central nervous system pediatric brain tumors.

About 50-65% of germ cell tumors are germinomatous, the rest are non- germinomatous.

What causes a non-germinomatous germ cell tumor? Who is affected?

During the normal development of a fetus, germ cells develop into an egg (in a girl) or sperm (in a boy). In rare cases, these cells migrate to the brain, producing a tumor. These tumors can spread to other parts of the brain and spine through cerebrospinal fluid (CSF). It is unclear why or how germ cells migrate.

Germ cell tumors mostly affect teenagers and young adults. Around half occur in children between the ages of 10 and 15.

It is much more common in boys than girls.

What are the symptoms of a non-germinomatous germ cell tumor?

Symptoms of germ brain cell tumors depend on the location of the tumor.

For tumors in the pineal gland region, children may experience hydrocephalus (swelling of the brain), headache, vomiting, fatigue, behavioral or cognitive changes, ataxia (uncoordinated body movement), and changes in vision.

Tumors in the suprasellar or pituitary gland region may cause early or delayed puberty, stunted growth, vision changes, and diabetes insipidus (a disorder characterized by intense thirst and passing large amounts of urine).

How is a non-germinomatous germ cell tumor treated?

Surgery is used to treat and biopsy a tumor to determine a diagnosis and treatment plan.

Surgeons may perform additional procedures if the tumor causes a blockage of cerebral spinal fluid (CSF). Surgeons create a small hole to relieve symptoms of hydrocephalus, the buildup of fluid inside the skull. In some cases, children may have ventriculoperitoneal shunt (VP shunt) surgically placed so excess fluid can drain into the abdomen.

Children may receive chemotherapy or radiation therapy to shrink the tumor and kill any remaining cancer cells.