How do germ cell tumors in infants and children differ from those in postpubertal males and females?


Germ cell tumors (GCTs) in the pediatric population differ significantly from adult GCTs in several respects. First, the incidence is much lower than in adults. Second, GCTs occur more commonly at extragonadal sites during the first several years. Third, except for ovarian dysgerminoma, which develops in girls after age 8, teratoma and yolk sac tumor (YST) are the only GCTs in this age group. The sacrococcygeal region is the most common extragonadal site, and teratoma is the most common type at this location. In the testis, YST is more common than teratoma, whereas in the ovary teratoma is more common than YST and there are twice as many mature teratomas as the immature type. YST is malignant. Teratoma is benign in children. Although the presence of immature elements per se does not affect prognosis, immature teratoma of high grade is significantly associated with foci of YST and higher stages of the disease. The overall prognosis is still excellent.


Germ Cell Germ Cell Tumor Testicular Germ Cell Tumor Mature Teratoma Gonadal Dysgenesis 
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  1. 1.
    Ulbright TM (2005) Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues. Mod Pathol 18:S61–S79.PubMedCrossRefGoogle Scholar
  2. 2.
    Ulbright TM (2004) Gonadal terstomas. Adv Anat Pathol 11:10–23.PubMedCrossRefGoogle Scholar
  3. 3.
    Heifetz SA, Cushing B, Giller R, Shuster JJ, Stolar CJH, Vinocur CD, Hawkins EP (1998) Immature teratomas in children: pathological considerations—a report from the Combined Pediatric Oncology Group/Children’s Cancer Group. Am J Surg Pathol 22:1115–1124.PubMedCrossRefGoogle Scholar
  4. 4.
    Reuter VE (2005) Origins and molecular biology of testicular germ cell tumors. Mod Pathol 18:S51–S60.PubMedCrossRefGoogle Scholar
  5. 5.
    Brosman SA (1979) Testicular tumors in prepubertal children. Urology 23:581–588.CrossRefGoogle Scholar
  6. 6.
    Grady RW, Ross JH, Kay R (1997) Epidemiological features of testicular teratoma in a prepubertal population. J Urol 158:1191–1192.PubMedCrossRefGoogle Scholar
  7. 7.
    Weissbach L, Altwein JE, Stiens R (1984) Germinal testicular tumors in childhood: report of observations and literature review. Eur Urol 10:73–85.PubMedGoogle Scholar
  8. 8.
    Marsden HB, Birch JM, Swindell R (1981) Germ cell tumours of childhood: a review of 137 cases. J Clin Pathol 34:879–883.PubMedCrossRefGoogle Scholar
  9. 9.
    Dehner LP (1983) Gonadal and extragonadal germ cell neoplasia of childhood. Hum Pathol 14:493–511.PubMedCrossRefGoogle Scholar
  10. 10.
    Harms D, Janig U (1986) Germ cell tumors of childhood: report of 170 cases including 59 pure and partial yolk-sac tumours. Virchows Arch Pathol Anat 409:223–239.CrossRefGoogle Scholar
  11. 11.
    Fraumeni JF Jr, Li FP, Dalager N (1973) Teratomas in children: epidemiologic features. J Natl Cancer Inst 51:1425–1430.PubMedGoogle Scholar
  12. 12.
    Grady RW, Ross JH, Kay R (1995) Patterns of metastaic spread in prepubertal yolk sac tumors of the testis. J Urol 153:1259–1261.PubMedCrossRefGoogle Scholar
  13. 13.
    Heerema-McKinney A, Harrison MR, Bratton B, Farrell J, Zaloudek C (2005) Congenital teratoma: a clinicopathologic study of 22 fetal and neonatal tumors. Am J Surg Pathol 29:29–38.CrossRefGoogle Scholar
  14. 14.
    Stamp IM, Barlebo H, Rix M, Jacobsen GK (1993) Intratubular germ cell neoplasia in an infant testis with immature teratoma. Histopathology 23:99–100.Google Scholar
  15. 15.
    Mnanivel C, Simonton S, Wold LE, Dehner LP (1988) Absence of intratubular germ cell neoplasia in testicular yolk sac tumors in children. Arch Pathol Lab Med 112:641–645.Google Scholar
  16. 16.
    Hawkins E, Heifetz SA, Giller R, Cushing B (1997) The prepubertal testis (prenatal and postnatal): its relationship to intratubular germ cell neoplasia—a combined Pediatric Oncology Group and Children#x2019;s Cancer Study Group. Hum Pathol 28:404–410.PubMedCrossRefGoogle Scholar
  17. 17.
    Krabbe S, Skakkebaek NE, Berthelsen JG, Eyben FV, Volsted P, Mauritzen K, Eldrup J, Nielsen AH (1979) High incidence of undetected neoplasia in maldescended testes. Lancet 1:999–1000.PubMedCrossRefGoogle Scholar
  18. 18.
    Dorman S, Trainer TD, Leeke D, Leadbetter G (1979) Incipient germ cell tumor in a cryptorchid testis. Cancer 44:1357–1362.PubMedCrossRefGoogle Scholar
  19. 19.
    Muller J, Skakkebaek NE, Nielsen OH, Graem N (1984) Cryptorchidism and testis cancer: atypical infantile germ cells followed by carcinoma in situ and invasive carcinoma in adulthood. Cancer 54:629–634.PubMedCrossRefGoogle Scholar
  20. 20.
    Armstrong GR, Buckley CH, Kelsey AM (1991) Germ cell expression of placental alkaline phosphatase in male pseudohermaphroditism. Histopathology 18:541–547.PubMedCrossRefGoogle Scholar
  21. 21.
    Muller J, Skakkebaek NE (1984) Testicular carcinoma in situ in children with the androgen insensitivity (testicular feminisation) syndrome. BMJ 288:1419–1420.PubMedCrossRefGoogle Scholar
  22. 22.
    Muller J, Skakkebaek NE, Ritzen M, Ploen L, Petersen KE (1985) Carcinoma in situ of the testis in children with 45, X/46, XY gonadal dysgenesis. J Pediatr 106:431–436.PubMedCrossRefGoogle Scholar
  23. 23.
    Soosay GN, Bobrow L, Happerfield L, Parkinson MC (1991) Morphology and immunohistochemistry of carcinoma in situ adjacent to testicular germ cell tumors in adults and children: implication for histogenesis. Histopathology 19:537–544.PubMedCrossRefGoogle Scholar
  24. 24.
    Hartwick W, Ro J, Ordonez N, Ayala A (1990) Testicular germ cell tumors under age 5: does intratubular germ cell neoplasia exist? Lab Invest 62:43A.Google Scholar
  25. 25.
    Renedo DE, Trainer TD (1994) Intratubular germ cell neoplasia (ITGCN) with p53 and PCNA expression and adjacent mature teratoma in an infant testis, an immunohistochemical and morphologic study with a review of the literature. Am J Surg Pathol 18:947–952.PubMedCrossRefGoogle Scholar
  26. 26.
    Hu LM, Phillipson J, Barsky SH (1992) Intra tubular germ cell neoplasia in infantile yolk sac tumor: verification by tandem repeat sequence in situ hybridization. Diagn Mol Pathol 1:118–128.PubMedGoogle Scholar
  27. 27.
    Rajpert-de Meyts E, Skakkebaek NE (1994) Expression of c-kit protein product in carcinoma-in-situ and invasive testicular germ cell tumors. Int J Androl 17:85–92.PubMedCrossRefGoogle Scholar
  28. 28.
    Jorgensen N, Reipert-de Meyets E, Graem N, Muller J, Giwercman A, Skakkebaek NE (1995) Expression of immunohistochemical markers for testicular carcinoma in situ by normal human fetal germ cells. Lab Invest 72:223–231.PubMedGoogle Scholar

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