Pathology and Cytogonetics of Germ Cell Tumours in Children

Abstract

This chapter analyzes pathology and cytogenetics of germ cell tumors in children. Germ cell tumors arise from primitive germ cell with a potential for differentiation along several pathways. The primordial germ cells are the progenitors of mature germ cells that appear at the end of the third gestational week and migrate from the yolk sac toward the developing gonads by the fifth week of embryonic life. Germ cell tumors in children can be divided into benign, malignant, and borderline. Mature teratomas—sasrococcygeal in infants and ovary in girls—are the most common benign germ cell tumors. Yolk sac tumors (endodermal sinus) either pure or mixed with other elements are the most common malignant type. The preliminary data from a series of 220 patients entered into the U.K. Children's Cancer Study Group's Germ Cell Tumor Studies I and II suggest that germinomas have the worst (76%) and teratomas the best (91%) survival. However, the survival differences between the various histological categories of malignant germ cell tumors were not statistically significant. The long-term survival for all patients entered onto germ cell study I, with a follow-up of 10 years was 83%.