Difference in the Germ Cell Tumors of the Reproductive Tract in Men and Women

Germ cell tumors (GCTs) constitute a remarkably heterogeneous group of neoplasms that can arise from the germ cells in the gonads or in extragonadal sites (mainly in the sacrococcygeal region, retroperitoneum, mediastinum, and central nervous system). Despite their common origin, germ cells can cause very different tumors in men and women. GCTs are uncommon in women, representing less than 5% of all ovarian neoplasms. Most ovarian carcinomas are epithelial in origin, accounting for more than 90% of the estimated 25,000 new cases of ovarian cancer diagnosed per year in the United States. The pathogenesis, clinical presentation, treatment, and outcome of ovarian germ cell and epithelial cancer are very different. On the other hand, cancer of the testis is predominantly germ cell and is the most common solid tumor in men between the ages of 20 and 35. This chapter discusses origin of germ cells, gender differences in epidemiology of GCTs, and discusses whether the biology and risk factors for GCTs are gender specific. The chapter also discusses diagnosis and treatment of male and female GCTs.