Solid Tumors

What are testicular tumors?
Testicular tumors generally occur in very young boys or in teenagers and young adults. Testicular tumors may be germ cell tumors or stromal tumors.

Germ cell tumors, or tumors that result from the abnormal development of germ cells, are more common. Germ cells are the cells that make up sperm and eggs and are part of our reproductive system.

A stromal tumor is a rare type of testicular tumor. Stromal tumors originate from the supportive tissue of the organ and may lead to hormone production. The two main types of stromal tumors are Leydig cell tumors and Sertoli cell tumors. Stromal tumors usually occur during childhood.

What are symptoms of testicular tumors?
Most boys and young men with testicular tumors notice a lump or sensation of heaviness in the testicle. Testicular tumors sometimes cause elevation in the hormone called beta-HCG, thus testicular tumors can sometimes result in breast enlargement.

Rarely, stromal testicular tumors can cause elevation of female or male sex hormones (androgens or estrogens) causing increased hair or breast enlargement.

Testicular tumors may be seen sporadically (without any underlying process) or in the setting of specific genetic syndromes or cancer predisposition. Men born with undescended testis are also at increased risk for testicular cancer.

How are testicular tumors diagnosed?
Evaluation for testicular tumors starts with a very thorough history, physical examination and family history looking carefully for findings such as signs of early breast development or increased testosterone.

During the initial evaluation for testicular tumors, an ultrasound is commonly ordered. Depending on the results of the ultrasound, additional imaging such as computerized tomography (CT) or magnetic resonance imaging (MRI) scans are often needed.

If a testicular mass is detected, it is important to obtain blood tests for tumor markers. Other blood tests are ordered as a part of routine care.

How are testicular tumors treated?
At Children’s of Minnesota, testicular tumors are treated using a multidisciplinary team approach including pediatric experts in oncology, surgery and urology. The surgical approach is specifically planned based on concern for tumor or growth.

Children with stage I testicular germ cell or stromal tumors are sometimes treated with surgery alone. Children with more aggressive tumors or tumors that have spread require chemotherapy in addition to surgery.

Careful attention is given to both potential short and long-term side effects of therapy so that children have the best chance for normal fertility and a long and healthy life.

About treatment for testicular tumors at Children’s Hospitals and Clinics of Minnesota
Our cancer and blood disorders program consistently achieves excellent results ranking it in the top 10 programs in the United States. Children’s Hospitals and Clinics of Minnesota treats the majority of children with cancer and blood disorders in Minnesota and provides patients access to a variety of clinical trials using ground-breaking new treatments. Through our renowned program, patients experience unparalleled family support, a nationally recognized pain management team, and compassionate, coordinated care.

Children’s participates in clinical trials for the management of testicular germ cell tumors. We also house the International Ovarian and Testicular Stromal Tumor Registry that collects information about these rare tumors from all over the world. The registry collects clinical and biologic information to lead to improved treatment and screening for children with these rare tumors.

If you or your child has been diagnosed with a testicular stromal tumor, contact your physician or the registry for more information regarding enrollment.

Contact us
If you are a family member looking for a Children’s oncologist, please call our clinic at (612) 813-5940.

If you are a health professional looking for consultation or referral information, please call Children's Physician Access at 1-866-755-2121 (toll-free) and ask for the on-call hematologist/oncologist.

What are ovarian tumors?
The ovary is one of a pair of female reproductive glands in females. Ovarian tumors make up approximately 1 percent of childhood cancer. Ovarian tumors seen in children and young adults are different from the tumors seen in older women. Among children, germ cell tumors are most common followed by stromal tumors. Epithelial ovarian tumors, the most common ovarian cancer in older women, are rare in pediatrics.

Germ cell tumors arise from the germ cells of the ovary. Stromal tumors arise from the supporting structures and cells of the ovary. Epithelial ovarian tumors arise from the covering or outer layer of the ovary.

What are symptoms of ovarian tumors?
Common symptoms that might be associated with ovarian tumors include abdominal pain, abdominal lump or changes in menstruation. Ovarian stromal tumors may include signs of unusual hormone production such as early puberty or signs of male hormone production such as excess hair, acne or voice changes.

Ovarian tumors may be seen sporadically (without any underlying process) or in the setting of specific genetic syndromes or cancer predisposition.

How are ovarian tumors diagnosed?
Evaluation for ovarian tumors starts with a thorough medical and family history, and physical examination. During the evaluation, the doctor looks carefully for any signs of early puberty or increased testosterone, thyroid nodules or skin or bony changes.

During the initial evaluation for suspected ovarian tumors, an ultrasound is commonly ordered. Depending on the results of the ultrasound, additional imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) scans might be needed.

Once an ovarian mass is detected, it is important to obtain blood tests for tumor markers, which include AFP and beta-HCG. Other blood tests for tumor markers such as LDH, inhibin A and B, mullerian inhibitory substance and CA125 may also be obtained.

How are ovarian tumors treated?
At Children’s of Minnesota, ovarian tumors are treated using a multidisciplinary team approach including pediatric experts from oncology, surgery and gynecology. Children’s has Minnesota’s only pediatric gynecologist. The surgical procedure chosen depends on the individual symptoms however most girls are eligible for fertility sparing surgery, or surgery that preserves the reproductive organs.

Children with stage I ovarian germ cell or stromal tumors are sometimes treated with surgery alone. Children with tumors that have ruptured or spread often require chemotherapy.

Careful attention is given to both potential short- and long-term side effects of therapy so that children have the best chance for normal fertility and a long and healthy life.

About treatment for ovarian tumors at Children’s Hospitals and Clinics of Minnesota
Our cancer and blood disorders program consistently achieves excellent results ranking it in the top 10 programs in the United States. Children’s Hospitals and Clinics of Minnesota treats the majority of children with cancer and blood disorders in Minnesota and provides patients access to a variety of clinical trials using ground-breaking new treatments. Through our renowned program, patients experience unparalleled family support, a nationally recognized pain management team, and compassionate, coordinated care.

Children’s also houses the International Ovarian and Testicular Stromal Tumor Registry that collects information about these rare tumors from all over the world. The registry collects clinical and biologic information to lead to improved treatment and screening for children with these rare tumors. If you or your child has been diagnosed with an ovarian tumor, contact your physician or the registry for more information regarding enrollment.

Contact us
If you are a family member looking for a Children’s oncologist, please call our clinic at (612) 813-5940.

If you are a health professional looking for consultation or referral information, please call Children's Physician Access at 1-866-755-2121 (toll-free) and ask for the on-call hematologist/oncologist.

There are two main types of tumors: benign and malignant. Benign tumors are slow growing, rarely spread and can usually be completely removed. Malignant tumors are often rapid growing, invasive and life threatening. Management of any tumor differs according to factors like the patient's age, the tumor location and the kinds of cells that make up the tumor.

Click on the following to learn about the various types of solid tumors.

What are germ cell tumors?
All germ cell tumors are the result of abnormal development of germ cells. They may be benign (when examined under a microscope the cells are found to be not cancerous) or malignant (when examined under a microscope the cells are found to be cancerous). There are several theories about the origin of these tumors. The best evidence suggests that most are due to abnormal growth of fetal germ cells that arise from the fetal yolk sac that start forming while the fetus is still growing in the mother’s womb. Normal migration of these germ cells may cause gonadal tumors, whereas abnormal migration produces extragonadal tumors, or tumors outside the gonads, such as in the belly, spine or brain.

Malignant germ cell tumors include several types of cancer, such as immature teratoma, yolk sac tumor and choriocarcinoma. They can destroy the testes or ovaries and can spread to other parts of the body.

Most germ cell tumors are not malignant but may require treatment because of the size or location of the tumor. Benign germ cell tumors include certain kinds of teratomas.

In children, germ cell tumors are found in the following areas:

  • Sacrococcygeal (tailbone area): 40%
  • Ovary: 25%
  • Testicle: 12%
  • Brain: 5%
  • Other (including the neck and chest): 18%

What are symptoms of germ cell tumors?
The signs and symptoms of germ cell tumors differ depending on where they are located. Symptoms may include:

  • Abdominal pain
  • Constipation
  • Mass protruding from area around lower back and buttocks
  • Painless mass in the scrotum
  • Shortness of breath

How are germ cell tumors diagnosed?
Germ cell tumors are usually found when a child comes to the doctor because of pain or a mass. Germ cell tumors within the brain may result in visual changes, headaches or vomiting. Because many conditions might have some of the same symptoms, it is important for a child with complaints like these to see a doctor to find out the cause.

Once a mass is suspected, a thorough physical exam, blood tests and additional imaging tests may be needed. Some germ cell tumors secrete tumor marks that can be measured in blood tests, including AFP, beta-HCG and CEA. For intracranial tumors, lumbar puncture may be performed to look for these tumor markers within the spinal fluid.

Additional imaging is often needed and may include ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) scans. Often a biopsy is needed to confirm the diagnosis and plan therapy.

If an ovarian or testicular mass is seen, blood tests to measure inhibin A and B may be done to assess for the presence of sex cord stromal tumor.

How are germ cell tumors treated?
Treatment of germ cell tumors depends on the location of the tumor. Surgery, chemotherapy and radiation therapy may be used alone or in some combination to treat the tumor.

  • Tumors in the chest, ovary or testis are often treated with surgery to obtain a biopsy and remove all or most of the tumor.
  • Surgery alone can cure some testicular and ovarian malignant germ cell tumors; however, others will require chemotherapy following surgery.
  • Intracranial germ cell tumors are sometimes managed with chemotherapy alone, without the need for surgery.
  • Germ cell tumors are also sensitive to radiation therapy, which is used occasionally for these tumors.
  • Stem cell transplant is also an option for some patients with recurrent disease.

About treatment for ovarian tumors at Children’s Hospitals and Clinics of Minnesota
Our cancer and blood disorders program consistently achieves excellent results ranking it in the top 10 programs in the United States. Children’s Hospitals and Clinics of Minnesota treats the majority of children with cancer and blood disorders in Minnesota and provides patients access to a variety of clinical trials using ground-breaking new treatments. Through our renowned program, patients experience unparalleled family support, a nationally recognized pain management team, and compassionate, coordinated care.

At Children’s Hospitals of Minnesota, children and young adults with germ cell tumors receive care from a comprehensive team of pediatric experts including oncologists, oncology nurses, gynecology, surgery, child life and others. In the case of ovarian tumors, a pediatric gynecologist may also be involved. Children’s has the only pediatric gynecologist in Minnesota.

Interventions such as physical therapy and hearing screening may help minimize the impact of any side effects associated with treatment for children at risk.

Children’s also houses the International Ovarian and Testicular Stromal Tumor Registry that collects information about these rare tumors from all over the world. The registry collects clinical and biologic information to lead to improved treatment and screening for children with these rare tumors. If you or your child has been diagnosed with a germ cell tumor, contact your physician or the registry for more information regarding enrollment.

Contact us
If you are a family member looking for a Children’s oncologist, please call our clinic at (612) 813-5940.

If you are a health professional looking for consultation or referral information, please call Children's Physician Access at 1-866-755-2121 (toll-free) and ask for the on-call hematologist/oncologist.

The solid tumor cancer program at Children's is one of the largest of its kind in the Upper Midwest. We diagnose and treat children with all types of solid tumors, including rhadomyosarcoma and other soft tissue sarcomas, Wilms' Tumor, neuroblastoma, hepatoblastoma and hepatocellular carcinoma, osteosarcoma, Ewing's sarcoma and other rare tumors. You can connect with our Tumor Registry here.

Our multidisciplinary team includes pediatric specialists from a wide variety of disciplines, including radiation oncology, surgery, anesthesia, pain and palliative care, psychology, Child Life, pharmacy, exercise medicine, physical therapy, occupational therapy, nutrition, integrative medicine and others.

We offer a wide range of therapies, including surgery, radiation therapy, chemotherapy, stem cell therapy, or a combination of these therapies.

Why Choose Children's Hospitals and Clinics of Minnesota?

One of the largest solid tumor programs in the region. Children's Hospitals and Clinics of Minnesota provides care for the majority of children diagnosed with solid tumors and rare tumors in the state of Minnesota and are the trusted regional treatment center for many children in North Dakota, South Dakota, Iowa and Wisconsin.

Access to the latest treatment options. At Children's, your child will have access to the most current national and international treatment protocols for chemotherapy and radiation through the Children's Oncology Group (COG). Through these memberships and participation your child is assured access to current treatment options.

Experts work together for your child. A multidisciplinary team works together to preserve eating and speaking skills for children and adolescents diagnosed with head and neck cancers. A unique, comprehensive approach using a team of pediatric hematologists/oncologists, otolaryngology surgeons, and rehabilitation therapists assures children get the best possible treatment options and prevent side effects of treatment.

Designated physical therapists specialized in cancer care and chemotherapy related issues work in the clinic gym with the medical team and your child to promote normal motor development during treatment and recovery.

Neuropsychological testing and the School Re-entry program offer testing, support and practical recommendations for your child and their school. Neuropsychologists work proactively with patients, families, and schools to help patients reach their maximum intellectual and social potential.

Special expertise in treatment of rare tumors. Because we diagnose over 200 children and adolescents with cancer annually, we are among the top 10 largest pediatric cancer centers in the nation and therefore diagnose children and teens with rare pediatric tumors. Treatment of children and adolescents diagnosed with a rare tumor is individualized utilizing the expertise of our specialists in addition to consultation with other experts from around the world. Your child will benefit from the evidence-based practice model we use that combines the best available current knowledge from the experienced clinical practitioner, current research, and patient preference.

Transition to Adult Care. As you get older, it will make sense for you to move to an adult care provider setting. At Children's, we will work with you and your adult care provider to make this change when the time is right and ensure that all important topics about your care are addressed.

Second opinions for children not seen in our program. At Children's, we provide consultation services for children who are not seen in our program but would like input from our expert team. If you or your child's doctor would like us to review your child's case, you may arrange to have health records and test results for your child sent to us. The child does not need to live in the area or be seen in our clinic.

What is a solid tumor?

A tumor is tissue that forms when cells grow and divide uncontrollably and no longer function properly. Sometimes piles of cells form a lump. Lumps, or tumors, that cause no harm, and are not cancerous, are called benign. Other tumors may be cancerous or malignant, and are referred to as sarcomas.