There are different combinations of mixed germ cell tumors, i.e. the components are not single, such as several types of germ cell tumors may be present. Generally, if the hormones such as HCG or AFP are elevated, the tumor size is not very large, and there is no serious symptom causing hydrocephalus, it is perfectly possible to start with chemotherapy or radiotherapy to reduce the size of the tumor, and some of them can even shrink to a small size. After some tumors shrink, then continue chemotherapy and radiation therapy, and if they no longer continue to shrink, surgery can be considered. By making the tumor smaller, the surgery is less risky and relatively safe. If the patient has very urgent symptoms, such as large tumor size, causing hydrocephalus or impaired consciousness, surgery can be considered first. Surgery is most effective if it can be done completely, but even if the surgery is done completely, post-operative adjuvant radiotherapy and chemotherapy are needed, depending on the size of the tumor and specific analysis.