The best treatment for your child’s germ cell tumor (GCT) or sex cord stromal tumor depends on a few things.

We look at the tumor type and its grade (how the cells appear). We also look at tumor stage. Staging is part of the diagnosis process. It tells you whether a tumor has spread to lymph nodes or other parts of the body.

We also consider your child’s needs and their age. We match the treatment to the tumor. Our goal is to cure the tumor with the fewest side effects.

MSK Kids doctors offer the following treatments:

Surgery

Surgery is the most common treatment for germ cell cancers and sex cord stromal tumors. These are common types of surgery.

Resection is surgery to remove the tumor. It’s important to try to prevent the tumor cells from spreading to nearby areas.

Our surgeons use a minimally invasive approach whenever possible. This means they operate through small incisions (cuts). This method causes less pain, fewer side effects, and has a faster recovery after surgery. They may need to do a larger surgery to take out all the tumor in 1 piece.

Radical inguinal orchiectomy (IN-gwih-nul OR-kee-EK-toh-mee) is surgery to remove 1 whole testis through an incision in the groin.

Unilateral salpingo-oophorectomy (sal-PIN-goh-oh-oh-foh-REK-toh-mee) is surgery to remove 1 ovary and 1 fallopian tube on the same side as the tumor. This type of surgery may keep your child’s ability to become pregnant when they’re older.

Surgery may be the only treatment needed for:

• Most teratomas
• Some early-stage testicular and ovarian GCTs
• People with early-stage sex cord stromal tumors

The best approach is to remove only the ovary and fallopian tube affected by the tumor. Since there are 2 ovaries and 2 fallopian tubes, there is less impact on fertility.

Chemotherapy

Sex cord stromal or germ cell tumor cells may not have spread to nearby lymph nodes or other areas. If so, chemotherapy (chemo) may not be needed.

If your child needs chemotherapy, they may get the drugs cisplatin, etoposide, and bleomycin. These chemotherapy medicines have been used together for nearly 50 years, and work well. We sometimes also use carboplatin and ifosafamide.

Radiation therapy

Your child may have radiation therapy if the cancer has come back. Radiation therapy uses high-energy beams to kill cancer cells.

The chance to get a promising new treatment

MSK Kids researchers have research studies, also known as clinical trials, to explore new therapies for young people with rare tumors. We have clinical studies that explore targeted therapies, which target the molecules that drive a tumor’s growth.

One example is the drug bevacizumab. It blocks the growth of blood vessels that supply tumors with nutrients. Your care team will tell you if a clinical trial is right for your child.

Side effects of pediatric germ cell and sex cord stromal tumor treatments

Treatments have different side effects. Your child’s side effects depend on the type of treatment they had. Your care team will tell you what to expect. They will support your child and help manage any side effects.

If your child has surgery, your surgeon will let you know how long the surgery may take. They will tell you how long your child may be in the hospital.

There may be some swelling and discomfort around the incision site. Our pain care team makes sure your child is as comfortable as possible. Your surgeon will tell you when your child can go back to their regular activities.

If your child has chemotherapy, side effects can include nausea and vomiting, less appetite, hair loss, and mouth sores. Radiation therapy can cause skin irritation and fatigue (feeling tired).

Not everyone who gets chemotherapy or radiation therapy has all these side effects.

Late effects of cancer treatment

Some children treated for cancer have side effects that start a long time after treatment. They can happen months or years after treatment. Examples of late effects of childhood cancer therapies include:

• Physical problems, such as trouble hearing, infertility (trouble getting pregnant), and kidney problems.
• Changes in feelings, mood, learning, thinking, or memory.
• Second cancers (new types of cancer), such as leukemia.

At MSK Kids, we try whenever possible to use treatments that have the best chance of curing the cancer with the lowest risk of late effects.

What to expect after treatment

We will keep monitoring (checking) your child’s health after their treatment ends. You must come in for visits every now and then so we can be sure the tumor is gone. We will do blood tests and scans to check for any signs it may have come back. Most children treated for GCTs or sex cord stromal tumors go on to live healthy lives.

We encourage the children we treat for these tumors to get follow-up care through the MSK Kids long-term follow-up program. They will assess your child carefully and look for the kinds of problems treatment can cause.

Our social workers provide counseling, offer information and support, and can guide you to resources. Child life specialists, teachers, and others on the MSK Kids team work together to meet your child’s needs beyond treatment.