
Extragonadal germ cell tumours are made up of cells that form during the early development of a fetus (unborn baby). In a growing fetus, germ cells typically move from a site near the middle of the body to the ovaries or testes (gonads). There they develop into eggs in females and sperm in males.
Treatment of extragonadal germ cell tumours depends on the location and type of the tumour. Generally, small tumours can be treated with radiation and large ones are treated with chemotherapy which is followed by radiation. The most common treatment option for nonseminomatous tumors is chemotherapy followed by surgical removal of any larger tumors that remain after chemotherapy.
Mid-chest area (mediastinum) — Seminomas usually are treated with high-dose radiation and sometimes with chemotherapy. Nonseminomas are treated with chemotherapy.

Lower-back area (presacral area) and retroperitoneal tumors— Chemotherapy is used to shrink the tumor as much as possible before it is removed surgically. If the entire tumor is not removed during surgery, a second course of chemotherapy may be given, followed by a second surgery to get the rest of the tumor.
Head (pineal area)— The tumor is removed surgically. Both non-seminomas and seminomas may be treated with radiation. However, because high-dose radiation can damage parts of the brain, some hospitals try a combination of chemotherapy and a lower dose of radiation, especially for non-seminomas.
Because doctors always are eager to determine the best treatment for rare types of cancer, your doctor may talk with you about the possibility of enrolling in a clinical trial. This is an experimental treatment program.
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