Germ Cell Tumors
Signs and Symptoms

Symptoms for germ cell tumors vary widely, depending on the type of tumor and its location. The tumors below and their symptoms are listed by their location in the body.

Gonadal Tumors

Gonadal tumors are located in the reproductive organs — the ovaries in girls and the testicles in boys.

  • Ovarian — In girls, ovarian germ cell tumors can be difficult to detect and may grow to a large size before they produce symptoms. These tumors usually aren't detected until age 10 or later. A possible sign is swelling of the abdomen but often, there are no symptoms in the early stage.


  • Testicular — Testicular tumors often are detected at an early age because they become noticeable in the scrotum or cause pain.

Extragonadal Tumors

Extragonadal tumors are located outside of the reproductive organs.

  • Mediastinum Tumors — These tumors are located in the cavity that contains the heart, large blood vessels, trachea, thymus and connective tissues. Malignant mediastinum tumors may cause chest pain, breathing problems, cough and fever.


  • Presacral Tumors — These tumors are located in the area above or in front of the sacral bone of the hip. A malignant presacral germ cell tumor usually appears as a mass in the lower abdomen or buttocks of an infant or young child. Tumors found in infants younger than 6 months old are more likely to be benign than those affecting older children. These tumors may cause difficulty passing urine or having a bowel movement and in older children may cause difficulty walking. Benign and malignant presacral germ cell tumors are much more common in children than in adults. Tumors in children younger than 6 months old are benign in 98 percent of cases. Tumors in children older than 6 months are malignant in about 65 percent of cases.


  • Pineal Gland Tumors — Tumors in the pineal gland, a pea-sized gland located in the middle of the brain, cause symptoms by pressing directly on parts of the brain or by interfering with the normal flow of cerebrospinal fluid, the clear fluid that circulates around the brain and spinal cord. Symptoms may include headache, nausea, vomiting, memory loss, lethargy, difficulty walking, inability to look upward, uncontrolled eye movements or double vision. A child with a tumor that begins to produce hormones may show physical signs of precocious puberty, or puberty at an abnormally young age. Almost all pineal germ cell tumors occur in patients younger than 40.


  • Sacrococcygeal Tumors — These tumors, located in the area of the tailbone or near the distal end of the spinal column, are the most common congenital tumor (meaning tumor that's present since birth) affecting newborns. Because these tumors are sometimes visible from the outside of the body, diagnosis is made early. Following treatment, the prognosis for this type of germ cell tumor is very favorable.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

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