Professionals use a combination of testaments to diagnose the type or stage of EGCT is present. Common testaments for EGCTs are a physical examination,<unk>  marker test, immunohistochemistry, cytogenetic analysis, MRI, chest x-ray, CT scan (CAT scan), ultrasound exam, and biopsy. Explanations for each testament are below. * Physical examination: a body check to look for signs of disease, such as a lump in the testicle in males or abnormal virginal bleeding in females. *<unk>  marker test: two<unk>  markers are tested, alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-hCG), to detect and diagnose the EGCTs. * Immunohistochemistry: the use of antibodies to detect the reaction of antigens in the human body. * Cytogenetic analysis: a method to discover abnormal arrangement of chromosomes in the<unk> <unk> s. * MRI: an instrument that uses magnetic field, radio waves, and a computer to investigate the condition inside the human body through a series of pictures. * Chest x-ray: an x-ray test that showed the area of chest with blood vessels, heart, lungs, and bones. * CT scan (CAT scan): an instrument can get more detailed pictures of the human body by using special x-ray. * Ultrasound exam: images are shown by the methodology of high-energy sound waves bouncing off the human tissues and organs. * Biopsy: using a microscope to examine abnormal<unk> s from the removed tissue from the human body. Through the images from multiple picture-taking testaments, abnormal circle-shaped tissues are shown. According to the size of the<unk> , patient's age and gender, specialists diagnose the stage of the EGCT. The method of biopsy presents the<unk> <unk> s characteristics through a microscope. Inside the<unk>  tissue, clustered of<unk> <unk> s is shown. Furthermore, by examining the<unk> <unk> s individually, it has various shapes and sizes where healthy<unk> s are in round shapes. The<unk>  marker test includes two markers, AFP and β-hCG, to detect and classify which type of cancer<unk>  is present. An increasing level in both markers indicates the sign of diagnosing<unk> <unk><unk> . AFP (IU/mL) or ng/mL is a protein which a very high concentration of AFP may lead to<unk> <unk><unk> . The AFP<unk>  marker had been used for the ovarian GCT or testicular GCT. The beta-human chorionic gonadotropin (β-hCG) is a hormone produced from the abnormal<unk>  tissue. The β-hCG test takes sample either from blood or urine. Also, this<unk>  marker test is commonly used for<unk> <unk><unk> s. Both the<unk>  marker test and immunohistochemistry measure AFP and β-hCG; however, the method of testing the markers is different, whereas immunohistochemistry discover the cancer by looking at the antibody-antigen interactions under a microscope. Classifications There are two types of classification for the<unk> . One is GCT biology and another is to classify EGCT into 3 types. Both classifications are used by professionals to diagnose the type of<unk>  the patient has by the assistance of multiple results from different testaments. The first classification organized the EGCTs into two types, gonadal and extragonadal<unk> -cell<unk> . Gonadal GCTs include Testicular GCTs in males and Ovarian GCTs in females.<unk>  extragonadal GCTs are<unk> <unk> s that had been spread out through tissue, lymph system or blood to other areas of the body other than the gonads. Testicular GCT A painless bump in the testes represents the testicular GCT in male. The Klinefelter syndrome Swyer syndrome may increase the risk of having testicular GCT. Two common age ranges for testicular GCT is before 4 years old or after puberty. A stage I testicular GCT is considered a low risk<unk>  where all ages of male may diagnose. Patients that are 11 years old or above, stage II to IV testicular GCT are classified as standard risk 1 (intermediate 1). The classification for<unk>  as standard risk 2 (intermediate 2) and poor risk are commonly discovered among patients who are under 11 years old. The common treatments for testicular GCTs are chemotherapy, surgery, and radiotherapy, where the medication of PEB (cisplatin, etoposide, and bleomycin) had been used commonly. Ovarian GCT It is also called Dysgerminoma. The common symptom of the ovarian GCTs is a pelvic mass with pain among female. However, it is not common among children where an approximate chance of 2.6 out of 100,000 female will diagnose the ovarian GCT. Common treatments are chemotherapy, surgery, and radiotherapy. According to the site of the<unk> , stage of the<unk> , and type of<unk>  to proceed appropriate treatments, where surgical resection is the most common treatment. Extragonadal GCT A mixed<unk> <unk><unk>  in the testes. On the left side shows yolk sac<unk> , and on the right side shows embryonal carcinoma. Under the classification of the biology GCT, there is a more detailed classification contains specific types of<unk>  extragonadal<unk> <unk><unk> . There are two types, teratomas, and malignant GCTs. Lists of these two categories and its subtypes are shown below. * Teratomas * Mature teratomas * Immature teratomas * Malignant GCTs * Seminomatous GCTs: seminoma, dysgerminoma,<unk> inoma * Non-seminomatous GCTs: yolk sac<unk>  (endodermal sinus<unk> , choriocarcinoma, embryonal carcinoma, gonadoblastoma, teratoma & yolk sac<unk>  * Mixed GCTs: a combination of EGCTs. Common combinations include teratoma & embryonal carcinoma & yolk sac<unk>  (11%), seminoma & embryonal carcinoma (16%), and teratoma & embryonal carcinoma (26%). The yolk sac<unk>  produce the AFP hormone, and the<unk> inomas, choriocarcinomas, and seminoma are<unk> s that produce the β-hCG hormone. The hormones that are produced by the<unk> s can be detected while proceeding testaments. Staging By classifying the EGCTs, the professionals identify the type of<unk>  by its location and patient's symptoms. After completing multiple testaments, the professionals may classify the stage of the<unk> s from the results. The EGCTs can be divided into three risk groups, low risk, intermediate risk (standard risk1 & 2), and poor risk. The survival rate is differed by the stage and risk groups of the<unk> : +The Low Risk Group Stage Survival % Age testis I 100 any age group ovary I 96 any age group extragonadal I 93 any age group +The Intermediate Risk Group Stage Survival % Age testis (S1) II ~ IV 98 <11 ovary (S1) II ~ IV 88 <11 extragonadal (S1) II ~ IV 85 <11 testis (S2) II ~ IV 88 ≥11 ovary (S2) II ~ IV 85 ≥11 extragonadal (S2) II ? ≥11 Abbreviation: S1 = Standard risk 1; S2 = Standard risk 2 +The Poor Risk Group Stage Survival % Age testis II ~ IV 83 ≥11 ovary II ~ IV 60 ≥11 extragonadal II ~ IV 51 ≥11
Extracranial germ cell tumor
Glial tumor
Central nervous system cyst
Dysembryoplastic neuroepithelial tumour
Neuroectodermal neoplasm
Central nervous system primitive neuroectodermal tumor
Primary central nervous system lymphoma
Primitive neuroectodermal tumor