From the Guidelines

Germ cell tumors in pediatric patients are malignant tumors that mainly occur in girls, adolescents, and younger women.

They include dysgerminomas, immature teratomas, embryonal tumors, and endodermal sinus (yolk sac) tumors 1
The median age at diagnosis is 16 to 20 years 1
Germ cell tumors are the predominant ovarian tumor in this age group 1
Gonadal dysgenesis is a risk factor for germ cell tumors 1

Women with malignant germ cell tumors have an excellent prognosis 1
The 5-year survival rate is more than 85% after appropriate treatment 1
Fertility-sparing surgery should be considered for those desiring fertility preservation, regardless of stage 1
Postoperative chemotherapy with bleomycin, etoposide, and platinum is recommended for most malignant ovarian germ cell tumors 1
Close monitoring and follow-up are essential due to the potential for late effects from treatment 1

From the Research

Pediatric germ cell tumors represent a diverse group of tumors that present from in utero through adolescence at many nongonadal locations, from the neck to the sacrococcygeal region 2
Germ cell tumors (GCTs) arising in infants, children, and adolescents present a set of special challenges, making up about 3% of malignancies in children aged 0-18 and nearly 15% of cancers in adolescents 3
Pediatric germ cell tumors are a diverse group of neoplasms with variable clinical behaviors, depending upon the age and site of presentation 4

Platinum-based chemotherapy has dramatically improved the event-free and overall survival outcomes of pediatric patients with malignant germ cell tumors over the past two decades 4
Patients with gonadal germ cell tumors have at least a 95% 5-year survival for early stage disease and at least a 85% 5-year survival for advanced stages 4
Introduction of cisplatin has improved the outcome of children with malignant germ cell tumors to nearly 90% 5 year survival 5
Carboplatin can successfully substitute for cisplatin during the treatment of pediatric germ cell tumors without sacrificing response or survival, with limited long-term effects such as nephrotoxicity and ototoxicity 6

Prognosis is dependent on tumor stage and location, with extragonadal germ cell tumors carrying a poorer prognosis and mediastinal location having the worst outcomes 4
Cytogenetic research studies have found chromosomal aberrations specific to some of these tumors that may serve as prognosticators and even direct therapy 4
Epidemiologic and molecular evidence suggests that GCTs in young children likely represent a distinct biologic group as compared to GCTs of older adolescents and adults, motivating the search for molecular targets for novel therapies 3