Surgery for Germ Cell Tumors

Surgeons at Hassenfeld Children’s Hospital at NYU Langone remove many types of benign and malignant germ cell tumors. The surgery used for germ cell tumors depends on the type, size, and location of the tumor. Chemotherapy may be used to shrink large tumors before surgery to make them easier to remove.

Surgery alone can cure some malignant germ cell tumors in the gonads—the ovaries or testicles. For germ cell tumors in the testicles, a surgeon removes the tumor and one or both testicles through a small incision in the groin. For ovarian germ cell tumors, which typically appear on one ovary, the surgeon removes the tumor, the ovary, and the fallopian tube through a small incision in the abdomen. Leaving one ovary or testicle when possible can help preserve fertility.

Surgery for extragonadal tumors—those located outside the gonads—depends on the location of the tumor. Some tumors can’t be completely removed because they are wrapped in nerves or arteries that supply blood to organs or are pressed against an important organ, such as the heart. A surgical procedure called tumor debulking, or cytoreduction, is used to remove as much of this kind of tumor or as many of these tumors as possible.

The doctor may perform a biopsy on nearby lymph nodes to determine if the cancer has spread beyond its original location. After surgery, chemotherapy is used to destroy any remaining malignant tumor or tumors, which are typically smaller than 1 centimeter.

Managing Side Effects

The side effects of surgery depend on the location and the size of tumor.

During surgery for testicular and ovarian germ cell tumors that affect the sacrum and coccyx, the bones at the bottom of the spine, the affected bones may have to be removed.

Your doctor discusses preserving your child’s fertility with you. A prosthesis of the testicle or testicles can be surgically implanted in the scrotum for a more natural appearance.