Immature sacrococcygeal teratomas: The doctor will use surgery to remove the tumor and possibly chemotherapy to kill remaining cancer cells. Chemotherapy drugs used include cisplatin, vinblastine and bleomycin.

Malignant testicular germ cell tumors: Usually, these tumors occur in boys younger than 4. For stage I tumors, the doctor may surgically remove one or both testicles by making an incision in the groin (a radical inguinal orchiectomy). For stages II through IV, surgery may be followed with cisplatin-based chemotherapy.

Treatment for adolescents is the same as for adults. See the separate disease summary for more details.

Malignant ovarian germ cell tumor: The doctor will probably use surgery to treat this tumor. The patient may receive a unilateral salpingo-oophorectomy, which removes the whole ovary with the cancer along with the adjoining fallopian tube. Another option is tumor debulking, which takes out as much of the cancer as possible without removing the whole organ. Young girls with early-stage tumors will receive unilateral salpingo-oophorectomy. Those with advanced tumors will receive unilateral salpingo-oophorectomy and possibly platinum-based chemotherapy. Adolescents with this disease receive the same treatment as adults. For more information, see the germ cell tumor section of the disease summary on adult ovarian cancer.

Extragonadal malignant germ cell tumor: These appear in the chest, abdominal, pelvic or sacrococcygeal area. The physician will remove smaller tumors with surgery and follow with chemotherapy. The doctor will perform a biopsy (surgical removal of tissue for examination under a microscope for cancer cells) on larger tumors, usually in the chest or pelvic area. This will be followed by platinum-based chemotherapy to shrink the tumor. Other chemotherapy drugs include cisplatin, etoposide and bleomycin or a regimen of carboplatin, etoposide and bleomycin. Surgery may follow.