Clinical Characteristics of Pediatric with Germ Cell Tumor: Experience in a Developing Country

Lelani Reniarti, Anisah Febri, Nur Melani Sari


Background: Germ cell tumor (GCT) occurs in 3% of pregnancy malignancies and increases by 15% during adolescence. In developing countries, the five-year survival rate is 98% and 80% for GCT earlier stage and malignant tumor, respectively. This study aimed to gather information about clinical manifestations of GCT and to evaluate the treatment outcome in pediatric GCT patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

Methods: A descriptive cross-sectional study design with a total sampling method was conducted using secondary data from the medical record of pediatric patients diagnosed with GCT from 2015 to 2018. Data on nutritional status, clinical characteristics, histopathology stage, hematological profiles, chemical markers, treatment methods, completeness of treatment, and outcome at the end of treatment were collected and presented using tables and charts.

Results: Of the 44 subjects, girls (77.3%) were predominant, with a mean age of 2 years old and normal nutritional status (59.1%). Patients generally had abdominal mass (97.7%) and most had intragonadal GCT (95.5%), with ovarium (76.2%) as the most common location. The most frequent GCT histopathology was yolk sac tumor (34.1%), with an Alpha-fetoprotein (AFP) level of >100.000 (6.8%). Almost all patients (97.7%) had undergone surgery; however, 47% of patients did not complete their treatment. At the end of treatment, the majority of patients survived (86.4%).

Conclusion: Germ cell tumor has various clinical characteristics. Understanding these characteristics will enable clinicians to make a proper diagnosis and provide immediate management that will lead to a better prognosis.


Alpha-fetoprotein, teratoma, yolk sac tumor

Full Text:



Olson TA. Germ cell tumor. In: Lanzkowsky P, Lipton JM, Fish JD, editors. Lanzkowsky's manual of pediatric hematology and oncology. 6th ed. Cambridge, Massachusetts: Academic Press; 2016. p. 555–67.

Hall C, Ritz B, Cockburn M, Davidson TB, Heck JE. Risk of malignant childhood germ cell tumors in relation to demographic, gestational, and perinatal characteristics. Cancer Epidemiol. 2017;46:42–9.

Pierce JL, Frazier AL, Amatruda JF. Pediatric germ cell tumors: a developmental perspective. Adv Urol. 2018;2018:9059382.

Lin X, Wu D, Zheng N, Xia Q, Han Y. Gonadal germ cell tumors in children: a restrospective review of a 10-year single-center experience. Medicine (Baltimore). 2017;96(26):e7386.

Kaatsch P, Häfner C, Calaminus G, Blettner M, Tulla M. Pediatric germ cell tumors from 1987 to 2011: incidence rates, time trends, and survival. Pediatrics. 2015;135(1):e136–43.

Poynter JN, Fonstad R, Tolar J, Spector LG, Ross JA. Incidence of intracranial germ cell tumors by race in the United States, 1992-2010. J Neurooncol. 2014;120(2):381–8.

Cecchetto G. Gonadal germ cell tumors in children and adolescents. J Indian Assoc Pediatr Surg. 2014;19(4):189–94.

İncesoy-Özdemir S, Ertem U, Şahin G, Bozkurt C, Yüksek N, Ören AC, et al. Clinical and epidemiological characteristics of children with germ cell tumors : a single center experience in a developing country. Turk J Pediatr. 2017;59(4):410–7.

Nasir IUI, Ashraf MI, Ahmed N, Shah MF, Pirzada MT, Syed AA et al. Clinical profile , treatment and survival outcomes of peadiatric germ cell tumours : a Pakistani perspective. J Pak Med Assoc. 2016;66(Suppl 3)(10):S119–21.

Poynter JN, Amatruda JF, Ross JA. Trends in incidence and survival of pediatric and adolescent patients with germ cell tumors in the United States , 1975 to 2006. Cancer. 2010;116(20):4882–91.

Srivastava R, Pushpam D, Dhawan D, Bakhshi S. Indicators of malnutrition in children with cancer : a study of 690 patients from a tertiary care cancer center. Indian J Cancer. 2015;52(2):199–201.

Pauniaho SL, Saonen J, Helminem M, Heikinheimo O, Vettenranta K, Heikinheimo M. Germ cell tumors in children and adolescents in Finland : trends over 1969 – 2008. Cancer Causes Control. 2014;25(10):1337–41.

Gaspar BL, Sharma P, Das R. Anemia in malignancies : pathogenetic and diagnostic considerations. Hematology. 2015;20(1):18–25.


Article Metrics

Abstract view : 24082 times
PDF - 293 times

 This Journal indexed by




Creative Commons License
AMJ is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License


View My Stats