A nonseminomatous germ cell tumor is a type of testicular cancer that forms in cells that produce sperm. The outlook for people with these types of tumors is positive, especially if diagnosed in the early stages.
A nonseminomatous germ cell tumor (NSGCT) is a type of testicular cancer.
This article goes into more detail about NSGCTs, including what causes them and how doctors diagnose and treat them.
The symptoms of NSGCTs are similar to those of other types of testicular cancer and may include:
- a lump in your testicle that you can feel
- swelling in one testicle that causes it to become larger
- a feeling of heaviness in your scrotum
- pain or discomfort in your testicles or scrotum
Seminoma vs. nonseminomatous germ cell tumors
Nonseminomatous germ cell tumors (NSGCTs) develop from germ cell subtypes that are more mature and specialized. Several cell subtypes can become NSGCTs. Some NSGCTs develop from only one of these subtypes, while others develop from a mixture of subtypes.
Testicular cancers can also have both seminoma and nonseminomatous cells. These are called “mixed germ cell tumors” and are treated as NSGCTs.
There are four types of NSGCTs. Generally, each type of NSGCT is more common in mixed tumors. Pure tumors of each type are rarer.
Embryonal carcinoma cells look like tissues found in early stage embryos when viewed under a microscope. They’re found in
Embryonal carcinomas are aggressive cancers. This means they have the potential to grow and spread rapidly.
Yolk sac carcinoma
Yolk sac carcinomas are named because they look like the yolk sac cells in an early embryo. They’re more common in children than in adults. They make up
Choriocarcinomas are made from cells that resemble components of the placenta. They’re aggressive, growing and spreading quickly.
Choriocarcinomas are rare and develop in adults. While pure choriocarcinomas are very rare, choriocarcinoma cells can be present in
Teratomas are tumors that look like each of the layers of a developing embryo under a microscope. They can be either mature or immature.
Mature teratomas can contain different types of adult tissue, such as hair, bone, and cartilage. Immature teratomas are less well-developed and look like tissue from an early embryo.
Doctors and researchers don’t know what exactly causes NSGCTs. In general, cancer happens due to changes in the DNA of cells that cause them to grow uncontrollably.
But some things are known to increase a person’s risk of testicular cancer. These include having:
- a personal or family history of testicular cancer
- an undescended testicle or testicles, called cryptorchidism
- germ neoplasia in situ, a type of precancer in the testicles
In the United States, the risk of testicular cancer is also
To make a diagnosis of NSGCT, your doctor will first take your medical history and do a physical exam. They will also feel your testicles for signs of any lumps, pain, or swelling.
Your doctor may order an ultrasound to help see whether a suspicious area is from a noncancerous health condition or from cancer.
Other imaging tests your doctor may order for NSGCT include:
Checking for tumor markers
Because NSGCTs can make high levels of proteins called tumor markers, blood tests for these markers can help your doctor diagnose NSGCT.
Tumor markers used for NSGCT include:
- alpha-fetoprotein (AFP), which is often elevated in embryonal carcinoma and yolk sac carcinoma
- human chorionic gonadotropin (hCG), which is often high in embryonal carcinoma and choriocarcinoma
- lactate dehydrogenase (LDH), which can be raised in testicular cancer, particularly if cancer is widespread
Biopsies vs. surgeries
Biopsies aren’t taken to diagnose testicular cancer. This is because taking a biopsy can help the cancer cells spread.
If your doctor is highly suspicious that you have testicular cancer, they may recommend removing the affected testicle in a procedure called a radical orchiectomy.
A lab can then analyze the removed testicle for the presence of cancer. If cancer is present, the cancer can be characterized further.
Treatment options for NSGCT may include one or a combination of the following:
- surgery to remove the affected testicle
- surgery to remove lymph nodes at the back of your abdomen
- chemotherapy, which typically includes one of the following regimens:
- etoposide and cisplatin (EP)
- etoposide, ifosfamide, and cisplatin (VIP)
After your treatment, your doctor will monitor you in case the cancer comes back. You’ll visit your doctor regularly for check-ins, some of which will involve imaging.
As time passes without a relapse, the period between doctors’ visits will become longer.
Are nonseminomatous germ cell tumors curable?
For some NSGCTs, particularly early stage cancers, it’s possible for there to be no traces of cancer left in your body after treatment. For example, stage 1 and 2 NSGCTs have a
However, it’s also possible for some NSGCTs to come back after treatment. This is why your doctor will want to continue to monitor you after your treatment concludes.
Your outlook with NSGCT can depend on several factors, such as:
- the type of NSGCT you have
- the stage of your NSGCT
- how aggressive your NSGCT is
- the type of treatment used and how the cancer responds to it
- the levels of tumor markers in your blood after treatment
- your age and overall health
NSGCTs can be divided into three outlook categories based on several factors. These outlook categories are good, intermediate, and poor.
According to the
- Good: 92% to 94%
- Intermediate: 80% to 83%
- Poor: 71%
The table below shows the
|SEER cancer stage||5-year survival rate|
|Localized (remains in testicles)||99%|
|Regional (spread to nearby tissues)||96%|
|Distant (spread to distant tissues)||73%|
NSGCTs are a type of testicular cancer that can develop in several germ cell subtypes. Germ cells are the type of cells that produce sperm.
Many NSGCTs contain a mixture of different cell subtypes. Some kinds of NSGCT are more aggressive than others.
Generally, the outlook for people with NSGCT is good, especially for early stage tumors. To get a more specific estimate of your outlook, be sure to have an open conversation with your healthcare team.