Survival rates for children with malignant germ-cell tumours have improved with the advent of platinum-based therapy. However, some patients are refractory to treatment or relapse. Extragonadal germ-cell tumours are more common in children than in adults; many patients are very young, with tumours localised to abdominal or pelvic sites that might be difficult to eradicate. The most common extragonadal germ-cell tumours in this population are sacrococcygeal teratomas. These tumours are usually diagnosed at birth when external lesions predominate. Presacral lesions containing malignant germ-cell tumor elements, such as yolk sac tumours, are noted later in the firstyears of life.
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