What is a germ cell tumor?
A germ cell tumor forms from germ cells, which are embryonic cells that develop into reproductive organs. Germ cell tumors primary occur in young people between the ages of 11 and 30. These tumors can be either benign or malignant. There are two main types of germ cell tumors of the brain – germinomas and non-germinomatous tumors; if they include aspects of both, they are called mixed germ cell tumors. Germ cell tumors include the germinoma, the teratoma, embryonal carcinoma, yolk sac (endodermal sinus) tumors, and choriocarcinoma. These tumors start and grow mainly in two areas in the center of the brain, the pineal region (where the pineal gland is located) and the suprasellar region (where the pituitary gland is located).
Symptoms of a germ cell tumor
Germ cell tumors in the brain can cause the following symptoms:
- Headache
- Vomiting
- Fatigue
- Feeling irritable
- Double vision and blurry vision
- Trouble looking up or focusing on close objects
- Coordination and balance issues
Increased fluid in the brain (hydrocephalus)Hormonal imbalance, including early or delayed puberty and stunted growth.
Causes of a germ cell tumor
Causes of germ cell tumors are not well known. Certain genetic conditions may predispose you to having a germ cell tumor.
Diagnosis of a germ cell tumor
If a brain tumor is suspected to be of germ cell origin, the work-up will include MRI imaging of the entire central nervous system (brain and spinal cord) due to their propensity to spread through the cerebrospinal fluid. Your doctor may also check for biomarkers in the blood and cerebrospinal fluid. Sometimes a biopsy will still be necessary to determine the diagnosis.
Treatment at Penn
Because diagnosis and treatment of germ cell tumors is often complicated and nuanced, the team at Penn includes neurosurgery, oncology, and radiation oncology. The multidisciplinary team draws on their extensive experience treating these tumors to come up with a personalized treatment plan for every patient.
Most germ cell tumors are treated with chemotherapy or a combination of chemotherapy and radiation therapy. The Abramson Cancer Center at the University of Pennsylvania offers the targeted personalized medicine approaches to the treatment of these tumors, as well as the latest in radiation technology including proton beam therapy.
Sometimes surgery is necessary to obtain a tissue biopsy or to resect some or all of the tumor. Penn neurosurgeons utilize the latest techniques in neuronavigation, neuroendoscopy, and minimally invasive approaches. Depending on the location of the tumor, the surgical team may include the Ear, Nose, and Throat specialists in addition to Neurosurgery. In addition, if hydrocephalus is present, a procedure may be necessary to divert the flow of the cerebrospinal fluid to lower the pressure in the head.