What Is Childhood Germinoma?
A germinoma is a type of germ cell tumor commonly found in the brain. Germ cells typically migrate to the gonads during fetal development and become an egg in female ovaries or sperm in male testes. If these germ cells don't migrate to the correct location, they can become trapped in the brain and multiply in areas where they shouldn’t.
- Germinoma is also known as a pure germ cell tumor.
- It responds well to treatment. Chemotherapy and radiation result in good outcomes.
- The other type of germ cell tumor of the brain is a non-germinomatous tumor. It secretes chemicals into the spinal fluid and bloodstream and requires more intensive treatment compared to germinoma.
At Dana-Farber/Boston Children's Cancer and Blood Disorders Center, we have treated many children with germinoma. Our Childhood Brain Tumor Center is a world-renowned destination for children with brain and spinal cord tumors.
Symptoms of Childhood Germinoma
Symptoms typically depend on where germinoma develops in the brain. For tumors in the pineal gland region, children can have the following symptoms:
- Hydrocephalus (swelling of the brain)
- Behavioral or cognitive changes
- Uncoordinated body movement (ataxia)
- Vision changes, including double vision and difficulty looking up
For tumors in the suprasellar or pituitary gland region, common symptoms include:
- Diabetes insipidus (an uncommon disorder characterized by intense thirst and the passing of large amounts of urine)
- Delayed puberty
- Early (precocious) puberty
- Stunted growth
- Vision changes, including loss of peripheral vision or decrease in vision
How We Diagnose Childhood Germinoma
Appropriate treatment starts with an accurate diagnosis. Doctors typically perform various diagnostic tests, including physical and neurological exams, advanced imaging studies, blood tests, and lumbar puncture.
How We Treat Childhood Germinoma
Our pediatric brain tumor specialists provide unique expertise in treating all forms of pediatric brain tumors, even rare tumors like germinomas.
Treatment options may include:
Tumors that are unlikely to spread receive radiation to the tumor and the area surrounding it. If the tumor is likely to spread beyond its original location, we may recommend radiation to other parts of the brain and spinal cord. If the tumor has already spread, we deliver radiation to the whole brain and spinal cord.
- Surgery: We may perform surgery to biopsy the tumor. Otherwise, surgery is generally not necessary as germinoma typically responds well to chemotherapy and radiation therapy.
- Chemotherapy: Chemotherapy treatment involves medications that interfere with a cancer cell’s ability to grow or reproduce. Doctors use it to shrink tumors and eliminate remaining cancer cells. Different groups of chemotherapy drugs work in different ways. They are generally systemic treatments. Your child may receive chemotherapy in the following ways:
- Orally, as a pill to swallow
- Intramuscularly, as an injection into the muscle or under the skin
- Intravenously (IV), as a direct injection into the bloodstream
- Intrathecally, as a direct injection into the spinal fluid
- Radiation therapy: Doctors may use radiation therapy, which involves using high-energy waves to shrink tumors or damage and destroy cancer cells.
Children with germinomas receive ongoing care in our pediatric cancer survivorship programs, including the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic for pediatric brain tumor survivors. These services address health and social issues, ranging from motor function evaluation and physical therapy to return-to-school and learning programs.
Long-term Outcomes for Children with Germinoma
Germinoma carry a relatively excellent prognosis. It's very unlikely that the tumor will spread outside the central nervous system. Overall, germinomas are cured in more than 90 percent of cases.
Childhood Germinoma Treatment Team
At Dana-Farber/Boston Children's, our team of brain tumor specialists includes neuro-oncologists, neurosurgeons, and neurologists. See a complete list of the specialists in our Childhood Brain Tumor Center.