Germ Cell Tumors in Children
Abstract
A retrospective review of 119 cases of germ cell tumors (GCT) in children who were treated at the Queen Sirikit National Institute of Child Health during 1987-1996 revealed teratomas in 87 percent, pure endodermal sinus tumor (EST) 10 percent and other GCT 3 percent of all patients. Of the 103 cases of teratomas, 80 were mature, 14 immature and 9 malignant teratomas.
Tumors were located in the sacrococcygeal area in 37 cases, ovary 30 cases, retroperitoneal area 21 cases, testis 12 cases, mediastinum 11 cases, central nervous system 6 cases, and others 2 cases.
Female to male ratio was about 2:1. Female predominance was noted in tumors of lower part of the body where as male predominance was upper part of the body. The numbers of male and female patients were almost equal in retroperitoneal GCT.
Behavior of GCT did not depend entirely on the histology of the tumors only, but also on the location of the tumors and the age at time of diagnosis and treatment. Immature teratomas behaved as benign tumors in most locations, except in the ovary of prepubertal or pubertal girls, where they behaved as malignant tumors.
Serum alpha fetoprotein (AFP) level correlated with the presence of EST component in tumors. Postoperative monitoring of serum AFP level appeared to be important in the long-term follow-up. Patients with GCT should be closely followed up for at least 3 years postoperatively.
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