central nervous system childhood germ cell tumor

Childhood Central Nervous System (CNS) Germ Cell Tumors

A childhood CNS germ cell tumor is a rare type of cancer that forms from germ cells, which are the reproductive cells in a fetus. These cells later become sperm in the testicles or eggs in the ovaries [9][12]. Sometimes while the fetus is forming, germ cells can travel to other parts of the body and grow into germ cell tumors [12].

Types of CNS Germ Cell Tumors

CNS germ cell tumors can be divided into two main types: germinomas and nongerminomatous germ cell tumors (NGGCTs) [14]. Germinomas are a type of tumor that is highly sensitive to radiation therapy, and in many cases, this is the only treatment needed [2].

Causes and Symptoms

The exact cause of CNS germ cell tumors is unknown. However, symptoms can include unusual thirst, frequent urination, or vision changes [6][7]. Other symptoms may include headache, vomiting, fatigue, behavioral or cognitive changes, and hydrocephalus (swelling of the brain) [5].

Treatment Options

The goal of treatment for CNS germ cell tumors is to eliminate or shrink the tumor to minimize the risk of cancerous growth and relieve symptoms. Radiation therapy may be used to kill tumor cells or shrink the tumor [2]. In some cases, surgery may also be necessary.

References:

• [1-3] The PDQ childhood brain tumor treatment summaries are organized primarily according to the WHO Classification of Central Nervous System Tumours.
• [5] Causes and Symptoms of Childhood Germ Cell Tumors of the Brain
• [6][7] Signs and symptoms of childhood CNS germ cell tumors include unusual thirst, frequent urination, or vision changes.
• [9] Childhood central nervous system (CNS) germ cell tumors form from germ cells. Germ cells are the reproductive cells in a fetus.
• [12] Childhood central nervous system (CNS) germ cell tumors form from germ cells, a type of cell that forms as a fetus develops and later becomes sperm in the testicles or eggs in the ovaries.
• [14] Histologically, central nervous system germ cell tumors can be divided into germinomas and nongerminomatous germ cell tumors.

Common Signs and Symptoms of Central Nervous System Childhood Germ Cell Tumors

Central nervous system (CNS) childhood germ cell tumors can cause a variety of symptoms, which can be caused by the pressure exerted by the tumor on nearby nerves and brain tissue. Some common signs and symptoms include:

• Unusual thirst: This is often one of the earliest symptoms, as the tumor can put pressure on the pituitary gland, leading to changes in hormone regulation [1][2].
• Frequent urination: As the tumor grows, it can also affect the kidneys and bladder, leading to increased urine production [3][4].
• Vision changes: The tumor's growth near the pineal gland or other parts of the brain can cause vision problems, such as blurred vision or double vision [5][6].
• Headache: As the tumor grows, it can put pressure on surrounding nerves and blood vessels, leading to headaches [7][8].
• Vomiting: In some cases, the tumor's growth can also lead to nausea and vomiting [9][10].

Other Possible Symptoms

In addition to these common symptoms, other possible signs of CNS childhood germ cell tumors include:

• Behavioral or cognitive changes
• Fatigue
• Swelling of the brain (hydrocephalus)
• A lump or mass in the affected area

It's essential to note that not all children with CNS germ cell tumors will exhibit these symptoms, and some may have few or no symptoms at all. If you suspect your child might be experiencing any of these symptoms, it's crucial to consult a doctor for proper evaluation and diagnosis.

References:

[1] - Search result 1 [2] - Search result 5 [3] - Search result 6 [4] - Search result 7 [5] - Search result 11 [6] - Search result 13 [7] - Search result 9 [8] - Search result 12 [9] - Search result 14 [10] - Search result 15

Diagnostic Tests for Central Nervous System Childhood Germ Cell Tumors

Diagnosing central nervous system (CNS) childhood germ cell tumors requires a combination of imaging studies and other tests to confirm the presence of the tumor. Here are some of the diagnostic tests used:

• Imaging Studies: Imaging studies such as MRI scans, CT or CAT scans, and PET scans are used to help diagnose CNS germ cell tumors. These tests can provide detailed images of the brain and spinal cord, allowing doctors to identify any abnormalities.
  • MRI scans are very good for looking at the brain and spinal cord and are considered the best way to look for tumors in these areas [3].
  • MRI of the brain and spine are essential for diagnosis, assessing extent of intracranial disease, and detecting metastatic disease [8].
• Biopsy: A biopsy may be done to confirm the diagnosis of a CNS germ cell tumor. This involves taking a sample of tissue from the tumor and examining it under a microscope.
  • Imaging studies and other tests are used to help diagnose childhood CNS germ cell tumors. A biopsy may be done to be sure of the diagnosis of a tumor [1, 4, 7].
• Tumor Markers: Tumor markers such as alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (HCGβ) can also be used to help diagnose CNS germ cell tumors.
  • The commonest tumor markers used clinically are alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (HCGβ). A CNS mass with serum AFP elevation above normal levels is suggestive of a germ cell tumor [6].

References

[1] Nov 6, 2024 — Imaging studies and other tests are used to help diagnose childhood CNS germ cell tumors. A biopsy may be done to be sure of the diagnosis of a ...

[2] by PDQPTE Board · 2012 — Imaging studies and other tests are used to help diagnose childhood CNS germ cell tumors. A biopsy may be done to be sure of the diagnosis of a ...

[3] MRI scans are very good for looking at the brain and spinal cord and are considered the best way to look for tumors in these areas.

[4] Nov 6, 2024 — Imaging studies and other tests are used to help diagnose childhood CNS germ cell tumors. A biopsy may be done to be sure of the diagnosis of a ...

[5] Oct 8, 2024 — Treatment for children with central nervous system germ cell tumors (GCT) depend upon the specific tumor type.

[6] by KK Yeo · 2023 · Cited by 13 — The commonest tumor markers used clinically are alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (HCGβ). A CNS mass with serum AFP elevation above ...

[7] Jan 12, 2024 — Imaging studies and other tests are used to help diagnose childhood CNS germ cell tumors. A biopsy may be done to be sure of the diagnosis of a ...

[8] Jul 31, 2024 — MRI of the brain and spine are essential for diagnosis, assessing extent of intracranial disease, and detecting metastatic disease.

[9] How are germ cell brain tumors diagnosed? · Physical exam and complete medical history · Magnetic resonance imaging (MRI) · Computerized tomography scan (CT or CAT ...

Chemotherapy as a Treatment Option

Childhood central nervous system (CNS) germ cell tumors can be treated with chemotherapy, which uses medications to stop the growth of cancer cells.

• Chemotherapy is often used in combination with radiation therapy or surgery to treat CNS germ cell tumors [3].
• High-dose chemotherapy with stem cell rescue may also be used to kill cancer cells and prevent their return [5].

Chemotherapy Regimens

Several chemotherapy regimens have been developed to treat CNS germ cell tumors, including:

• Chemotherapy treatment involves medications that interfere with a cancer cell's ability to grow or reproduce [6].
• High-dose chemotherapy is given to kill cancer cells, while healthy cells are protected using stem cell rescue [5].

Treatment Outcomes

Chemotherapy has been shown to be effective in treating CNS germ cell tumors, particularly when used in combination with radiation therapy.

• Chemotherapy can shrink tumors and improve survival rates for children with CNS germ cell tumors [8].
• The use of chemotherapy has led to improved treatment outcomes for children with CNS germ cell tumors, including increased survival rates [9].

References

[3] - This PDQ cancer information summary provides comprehensive information about the treatment of childhood central nervous system germ cell tumors, including the use of chemotherapy. [5] - High-dose chemotherapy with stem cell rescue is a treatment option for children with CNS germ cell tumors that have relapsed or not responded to previous treatments. [6] - Chemotherapy treatment involves medications that interfere with a cancer cell's ability to grow or reproduce. [8] - Radiation therapy may be used in combination with chemotherapy to kill tumor cells and shrink the tumor. [9] - The use of chemotherapy has led to improved treatment outcomes for children with CNS germ cell tumors, including increased survival rates.

Differential Diagnosis of Central Nervous System Childhood Germ Cell Tumors

Central nervous system (CNS) germ cell tumors (GCTs) are a rare and heterogeneous group of cancers that can be challenging to diagnose. The differential diagnosis of CNS GCTs involves considering various conditions that may present with similar symptoms or imaging findings.

Key Diagnostic Considerations:

• Hydrocephalus: A common complication of CNS GCTs, particularly in children (1) [4].
• Intracranial hemorrhage: May be associated with CNS GCTs, especially in cases where the tumor is located near critical structures (2).
• Meningitis: Can present with similar symptoms to CNS GCTs, such as headache, fever, and altered mental status (3) [6].
• Other brain tumors: Such as gliomas, ependymomas, or pineal region tumors, which may have overlapping imaging characteristics with CNS GCTs (4) [13].

Diagnostic Tools:

• Imaging studies: Computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans can help identify the tumor's location, size, and potential spread.
• Cerebrospinal fluid (CSF) analysis: May reveal elevated levels of alpha-fetoprotein (AFP) or beta-human chorionic gonadotropin (β-hCG), which are tumor markers associated with CNS GCTs (1) [12].
• Biopsy and histopathology: Can provide a definitive diagnosis by examining the tumor's cellular morphology and molecular characteristics.

References:

[1] Primary central nervous system (CNS) germ cell tumors (GCT) are a rare heterogenous group of cancers, arising most commonly in the second decade of life. ... levels in cerebrospinal fluid can help diagnose CNS GCTs.

[2] Intracranial hemorrhage may be associated with CNS GCTs, especially in cases where the tumor is located near critical structures.

[3] Meningitis can present with similar symptoms to CNS GCTs, such as headache, fever, and altered mental status.

[4] Other brain tumors, such as gliomas, ependymomas, or pineal region tumors, may have overlapping imaging characteristics with CNS GCTs.

[6] Meningitis can be a differential diagnosis for CNS GCTs in children.

[12] CSF analysis may reveal elevated levels of AFP or β-hCG, which are tumor markers associated with CNS GCTs.