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Germ cell tumor
Classification and external resources
ICD-10 C56., C62., D27., D29.2
ICD-9 183, 186, 220, 222.0
ICD-O: 9060-9100
eMedicine med/863 

A germ cell tumor (GCT) is a neoplasm derived from germ cells. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The International Classification of Diseases for Oncology (ICD-O is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Germ cells are progenitors of the Gametes. These singled out cells move through the gut to the developing Gonads and undergo mitotic proliferation followed Germ cells normally occur inside the gonads (ovary and testis). "Ovaria" redirects here This is also a proposed section and a Synonym of Solanum. The testicle (from Latin testiculus, diminutive of testis, meaning "witness" virility plural testes) is the male Germ cell tumors that originate outside the gonads may be birth defects resulting from errors during development of the embryo. A congenital disorder is a disease or disorder that is present at birth An embryo (from Greek:, plural, lit "that which grows" from en- "in" + bryein "to swell be full" is a multicellular

Contents

Etiology

Some investigators suggest that this distribution arises as a consequence of abnormal migration of germ cells during embryogenesis. Others hypothesize a widespread distribution of germ cells to multiple sites during normal embryogenesis, with these cells conveying genetic information or providing regulatory functions at somatic sites.

Extragonadal germ cell tumors were thought initially to be isolated metastases from an undetected primary tumor in a gonad, but it is now known that many germ cell tumors are congenital and originate outside the gonads. Metastasis ( Greek: displacement μετά=next + στάσις=placement, plural metastases) sometimes abbreviated mets, The gonad is the organ that makes Gametes The gonads in males are the Testes and the gonads in Females are the Ovaries. A congenital disorder is a disease or disorder that is present at birth The most notable of these is sacrococcygeal teratoma, the single most common tumor diagnosed in babies at birth. See also Teratoma Sacrococcygeal teratoma (SCT is a Teratoma (a kind of tumor located at the base of the Coccyx (tailbone

Classification

Germ cell tumors are classified by their histology,[1] regardless of location in the body. Histology (from the Greek = 'tissue' is the study of the microscopic anatomy of cells and tissues of Plants and

Tumor ICD-O Peak Age (yr) Benign or malignant Histology Tumor marker
Germinoma including dysgerminoma and seminoma 9060/3 40-50 Malignant Sheets of uniform polygonal cells with cleared cytoplasm; lymphocytes in the stroma 10% have elevated hCG
Embryonal carcinoma 9070/3 20-30 Malignant Poorly differentiated, pleomorphic cells in cords, sheets, or papillary formation Pure tumors do not secrete hCG, AFP
Endodermal sinus tumor, also known as yolk sac tumor (EST, YST) 9071/3 3 Malignant Poorly differentiated endothelium-like, cuboidal, or columnar cells 100% secrete AFP
Choriocarcinoma 9100/3 20-30 Malignant Cytotrophoblast and syncytiotrophoblast without villus formation 100% secrete hCG
Teratoma including mature teratoma, dermoid cyst, immature teratoma, teratoma with malignant transformation 9080/0-9080/3 0-3, 15-30 Mature teratoma, dermoid cyst usually benign (but follow-up required); others usually malignant Very variable, but "normal" tissues are common Pure tumors do not secrete hCG, AFP
Polyembryoma 9072/3 15-25  ?  ?  ?
Gonadoblastoma 9073/1  ?  ?  ?  ?
Mixed 15-30 Malignant Depends on elements present Depends on elements present

Germ cell tumors are broadly divided in two classes:[2]

The two classes reflect an important clinical difference. Compared to germinomatous tumors, nongerminomatous tumors tend to grow faster, have an earlier mean age at time of diagnosis (~25 years versus ~35 years, in the case of testicular cancers), and have a lower 5 year survival rate. Testicular cancer is Cancer that develops in the Testicles a part of the Male reproductive system The survival rate for germinomatous tumors is higher in part because these tumors are exquisitely sensitive to radiation, and they also respond well to chemotherapy. The prognosis for nongerminomatous has improved dramatically, however, due to the use of platinum-based chemotherapy regimens. [3]

Teratocarcinoma is an old name for a germ cell tumor that is a mixture of teratoma and embryonal carcinoma. A teratoma is a type of neoplasm. The word teratoma comes from Greek and means roughly "monstrous tumor" The Embryonal Carcinoma is one of the several types of testicular (or ovarian) Germ cell tumors, which also include the Seminoma ( Dysgerminoma In more modern usage, this kind of mixed germ cell tumor may be known as a teratoma with elements of embryonal carcinoma, or simply as an embryonal carcinoma.

Location

Despite their name, germ cell tumors occur both within and outside the ovary and testis. "Ovaria" redirects here This is also a proposed section and a Synonym of Solanum. The testicle (from Latin testiculus, diminutive of testis, meaning "witness" virility plural testes) is the male

Main article: Ovarian cancer
Main article: Testicular cancer

In females, germ cell tumors account for 30% of ovarian tumors, but only 1 to 3% of ovarian cancers in North America. In Anatomy, the head of an Animal is the Rostral part (from Anatomical position that usually comprises the Brain, Eyes The pineal gland (also called the pineal body, epiphysis cerebri, or epiphysis) is a small endocrine gland in the vertebrate Brain The Sella turcica (literally Turkish saddle is a saddle-shaped depression in the Sphenoid bone at the base of the Human Skull. The mouth, buccal cavity, or oral cavity is the first portion of the Alimentary canal that receives food and begins digestion by mechanically breaking up A teratoma is a type of neoplasm. The word teratoma comes from Greek and means roughly "monstrous tumor" The neck is the part of the Body on many limbed Vertebrates that distinguishes the head from the Torso or trunk The mediastinum is a non-delineated group of structures in the Thorax (chest surrounded by Loose connective tissue. Malignant mediastinal germ cell tumors of various histologies were first described as a clinical entity approximately 50 years ago The pelvis (pl pelvises or pelves) or pelvic girdle is the irregular bony structure located at the base of the spine (properly known See also Teratoma Sacrococcygeal teratoma (SCT is a Teratoma (a kind of tumor located at the base of the Coccyx (tailbone "Ovaria" redirects here This is also a proposed section and a Synonym of Solanum. Ovarian cancer is a cancerous growth arising from an Ovary. The cancer most commonly forms in the lining of the ovary (resulting in epithelial The testicle (from Latin testiculus, diminutive of testis, meaning "witness" virility plural testes) is the male Testicular cancer is Cancer that develops in the Testicles a part of the Male reproductive system Ovarian cancer is a cancerous growth arising from an Ovary. The cancer most commonly forms in the lining of the ovary (resulting in epithelial In younger women germ cell tumors are more common, thus in patients under the age of 21, 60% of ovarian tumors are of the germ cell type, and up to one-third are malignant. Malignant (from the Latin roots mal- = "bad" and -genus = "born" is a medical term used to describe a severe and progressively worsening disease In males, germ cell tumors of the testis occur typically after puberty and are malignant (testicular cancer). Testicular cancer is Cancer that develops in the Testicles a part of the Male reproductive system In neonates, infants, and children younger than 4 years, the majority of germ cell tumors are sacrococcygeal teratomas. CHILD syndrome (or congenital hemidysplasia with ichthyosiform erythroderma and limb defects) is a genetic disorder See also Teratoma Sacrococcygeal teratoma (SCT is a Teratoma (a kind of tumor located at the base of the Coccyx (tailbone

Persons with Klinefelter's syndrome have a 50 times greater risk of germ cell tumors (GSTs)[4]. Klinefelter's syndrome, 47XXY or XXY syndrome is a condition caused by a Chromosome Aneuploidy. In these persons, GSTs usually contain nonseminomatous elements, present at an earlier age, and seldom are gonadal in location.

Prognosis

The 1997 International Germ Cell Consensus Classification[5] is a tool for estimating the risk of relapse after treatment of malignant germ cell tumor.

A small study of ovarian tumors in girls[6] reports a correlation between cystic and benign tumors and, conversely, solid and malignant tumors. A cyst is a closed sac having a distinct membrane and Division on the nearby tissue. Because the cystic extent of a tumor can be estimated by ultrasound, MRI, or CT scan before surgery, this permits selection of the most appropriate surgical plan to minimize risk of spillage of a malignant tumor.

Research

Main article: Cancer research
Main article: Clinical trial

Germ cell tumors of children are the subject of clinical research by the worldwide Children's Oncology Group (COG), in a number of studies coordinated by Dr. Cancer research is research into Cancer in order to identify causes and develop strategies for prevention diagnosis treatments and cure In health care clinical trials are conducted to allow safety and Efficacy data to be collected for new drugs or devices Clinical research is a branch of Medical science that determines the safety and effectiveness of Medications devices, diagnostic products The Children's Oncology Group (COG is a Worldwide Clinical trial cooperative group supported by the National Cancer Institute (NCI and fashioned with John Cullen, MD. [7]

Intracranial Germ Cell Tumors have been studied through the International CNS GCT Study Group. Under the direction of Jonathan Finlay, the program director, three international treatment studies have been initiated since 1990 with the goal to maintain a high rate of cure while minimizing the late effects of treatment. In Medicine, a late effect is a condition that appears after the acute phase of an earlier causal condition has run its course

References

  1. ^ Ulbright TM (2005). "Germ cell tumors of the gonads: review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues. ". Mod. Pathol. 18 Suppl 2: S61-79. doi:10.1038/modpathol.3800310. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 15761467.   PubMed free full text
  2. ^ eMedicine - Germinoma, Central Nervous System : Article by Daniel D Mais, MD. Retrieved on 2007-11-03. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 644 - Umar ibn al-Khattab, the second Muslim Caliph, is killed by a Persian slave in Medina.
  3. ^ Robbins, Basic Pathology; ISBN 0-7216-9274-5, 7th edition, pg 664.
  4. ^ Mediastinal germ cell tumor in a child with precocious puberty and Klinefelter syndrome. Gregory G. Bebb, Frederic W. Grannis, Jr, Isaac B. Paz, Marilyn L. Slovak, Robert Chilcote. Ann Thorac Surg 1998;66:547-548. Abstract
  5. ^ International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol. 1997 Feb;15(2):594-603 PubMed abstract
  6. ^ Stankovic ZB, Djukic MK, Savic D, Lukac BJ, Djuricic S, Sedlecki K, Zdravkovic D (2006). "Pre-operative differentiation of pediatric ovarian tumors: morphological scoring system and tumor markers. ". J. Pediatr. Endocrinol. Metab. 19 (10): 1231-8. PMID 17172084.  
  7. ^ CureSearch.org press release re Germ Cell Cancer

See also

External links

Embryonic stem cells (ES cells are Stem cells derived from the inner cell mass of an early stage Embryo known as a Blastocyst.
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