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Stages of Childhood Extracranial Germ Cell Tumors

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    When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

    The following stages are commonly used for childhood nonseminoma testicular germ cell tumors:

    Stage I

    In stage I, the cancer is found only in the testicle and is completely removed by surgery. Tumor marker levels return to normal after surgery.

    Stage II

    In stage II, the cancer is removed by surgery and some cancer cells remain in the scrotum or cancer that can only be seen with a microscope has spread to the scrotum or spermatic cord. Tumor marker levels do not return to normal after surgery and may increase.

    Stage III

    In stage III, the cancer has spread to one or more lymph nodes in the abdomen and is not completely removed by surgery. The cancer that remains after surgery can be seen without a microscope.

    Stage IV

    In stage IV, the cancer has spread to distant parts of the body such as the liver.

    The following stages may be used for childhood ovarian germ cell tumors:

    Stage I

    In stage I, the cancer is in the ovary and can be completely removed by surgery.

    Stage II

    In stage II, one of the following is true:

    • The cancer is not completely removed by surgery. The remaining cancer can be seen with a microscope only.
    • The cancer has spread to the lymph nodes and can be seen with a microscope only.
    • The cancer has spread to the capsule (outer covering) of the ovary.

    Stage III

    In stage III, one of the following is true:

    • The cancer is not completely removed by surgery. The remaining cancer can be seen without a microscope.
    • The cancer has spread to lymph nodes and the lymph nodes are 2 centimeters or larger.
    • The cancer is found in fluid in the abdomen.
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