After a childhood extracranial germ cell tumor has been diagnosed, tests are done to find out if cancer cells have spread from where the tumor started to nearby areas or to other parts of the body.
The process used to find out if cancer
has spread from where the tumor
started to other
parts of the body is called staging. The information gathered from the
staging process determines the stage
of the disease. It is important to know
the stage in order to plan treatment. In some cases, staging may follow surgery
to remove the tumor.
The following procedures may be used:
(magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the lymph nodes. This procedure is also called nuclear magnetic resonance imaging.
(CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest or lymph nodes, taken from different angles. The pictures are made by a computer linked to an x-ray
machine. A dye
may be injected
into a vein
or swallowed to help the organs
show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive
material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.
Paracentesis: The removal of fluid from the space between the lining of the abdomen
and the organs in the abdomen, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels
to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels
to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells
break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor
tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if an extracranial germ cell tumor spreads to the liver, the cancer cells in the liver are actually cancerous germ cells. The disease is metastatic extracranial germ cell tumor, not liver cancer.
Stages are used to describe the different types of extracranial germ cell tumors.
Stage III: In stage III, cancer
is found in one or both ovaries
and has spread to other parts of the abdomen. Cancer that has spread to the surface of the liver
is also stage III disease.
Stage III is divided into stage IIIA, stage IIIB, and stage IIIC:
Stage I: In stage I, the cancer
is in one place and can be completely removed by surgery. For tumors
in the sacrum
(bottom part of the spine), the sacrum and coccyx are completely removed by surgery. Tumor marker
levels return to normal after surgery.
Stage II: In stage II, the cancer
has spread to the capsule
(outer covering) and/or lymph nodes. The cancer is not completely removed by surgery
and the cancer remaining after surgery can be seen with a microscope
only. Tumor marker
levels do not return to normal after surgery or increase.
Stage III: In stage III, one of the following is true:
is not completely removed by surgery. The cancer remaining after surgery can be seen without a microscope.