IMMATURE TERATOMA OF THE OVARY

  • 1 November 1986
    • journal article
    • research article
    • Vol. 68  (5) , 624-629
Abstract
Forty-one patients with pure immature teratoma of the ovary treated at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston [Texas] from 1944 to 1985 were reviewed. The median age of these patients was 17 years. The most common symptom was abdominal pain, which occurred in 39 (95%) patients. FIGO stages included 24 patients with stage I, four with stage II, 12 with stage III, and one stage IV. The tumors ranged in size from 6 to 31 cm in greatest diameter, with a median of 17 cm. Of 39 cases reexamined microscopically, four were grade 1 tumors, 22 were grade 2 tumors, and 13 were grade 3 tumors. Initial surgery included ovarian cystectomy in one patient, unilateral salpingo-oophorectomy in 27 patients, and bilateral salpingo-oophorectomy in 13 patients. Fifteen of 16 patients treated with surgery alone developed recurrent disease; 11 are surviving after further therapy. Two patients died after treatment with radiotherapy plus chemotherapy. Twenty-one patients received a combination of vincristine, actinomycin-D, and cyclophosphamide postoperatively, and 18 are alive and well. One of two patients who received other combination regimens is alive and well. Therefore, 29 of the 41 patients (71%) are alive and well. Optimal management of patients with pure immature teratoma of the ovary consists of initial surgery (with preservation of a normal contralateral ovary in most patients) followed by combination chemotherapy in all patients except those with stage I, grade 1 disease; the latter may be treated safely with surgery alone.