Germ cell tumors.

Germ cell tumors are relatively uncommon childhood tumors. Several interesting characteristics distinguish them from other tumors. (1) Abnormal migration of primordial germ cells results in the frequent occurrence of extragonadal germ cell tumors in children. (2) Serum markers exist to allow evaluation of extent of resection and development of recurrent tumor. (3) The introduction of modern chemotherapy including cisplatin, etoposide, and bleomycin has significantly improved survival of these children. Optimal therapy includes complete surgical resection, accurate histological examination, and selective use of chemotherapy. Mature and immature teratomas at any site and stage I testicular cancers are managed by observation alone, whereas all other tumors require chemotherapy.