Pediatric Germ Cell Tumor

Germ cell tumors are rare pediatric neoplasms and represent only approximately 3.5% of tumors in children [1]. The evaluation of these tumors is particularly challenging because there are two distinct incidence peaks for germ cell tumors in children and adolescents. The initial peak occurs between 0 - 4 years of age in infants and young children. These tumors arise at an earlier point in embryologic development and are known as Type I GCT. The second incidence peak begins around the onset of puberty and the incidence rises dramatically in adolescents and young adults (Type II GCT). Germ cell tumors are the most frequent diagnosis between ages 15-30 yrs, accounting for 15% of all malignancies encountered in this age group [2] [Overview of Adolescent and Young Adult Oncology Peter F. Coccia Journal of Oncology Practice 2019 15:5, 235–237]. Germ cell tumors arise primarily in the gonads, including testis and ovary with testicular GCT occurring ten times more frequently than ovarian GCT. GCT also may occur in a wide spectrum of extragonadal sites due to aberrant embyrologic migration of the primordial germ cell into the gonadal ridge. Extragonadal GCT are most commonly encountered in the sacrococcygeal region, retroperitoneum, and mediastinum. CNS germ cell tumors also occur, although discussion of this distinct group of neoplasms is beyond the scope of this review.