Your child will have a number of tests to investigate their symptoms and confirm a diagnosis of a germ cell tumour, including:
- medical history and physical examination, including a neurological examination
- eye examination
- blood tests
- medical imaging, which may include
- computed tomography (CT) scan
- magnetic resonance imaging (MRI)
- biopsy – where a small sample of the tumour is removed to be examined under a microscope. The sample can also be tested for genetic changes that can help determine the best type of treatment for your child
- lumbar puncture (spinal tap) – where a sample of cerebrospinal fluid is taken to be examined under a microscope.
These tests are explained in more detail in How is cancer diagnosed?.
If your child is diagnosed with a germ cell tumour, some of the diagnostic tests will also help to stage the tumour. Staging determines where the tumour is, how big it is and whether it has spread to other parts of the body. This is important to determine the outlook (prognosis) for your child, and to decide on the best options for treatment.
There is no standard staging system for germ cell tumours in the brain. Instead, tumours are staged based on a range of factors that are classified into different risk groups.
For other types of germ cell tumours, there are different ways to assess the stage or extent of the cancer. Some of the most common ways are described below. For more information about staging, see the publications from the National Cancer Institute.
Germ cell tumours that are not in the brain can be staged as follows:
- Stage I – the tumour is only in 1 place in the body and has been completely removed by surgery.
- Stage II – the cancer has spread to the outer covering of the organ, or to nearby lymph nodes. Surgery has removed all visible cancer, but some cancer cells remain.
- Stage III – surgery cannot remove all the visible cancer, or the cancer has spread to the lymph nodes.
- Stage IV – the cancer has spread to other parts of the body such as the lungs, liver, brain or bone.