BENIGN AND MALIGNANT TERATOMAS IN CHILDREN - ANALYSIS OF 85 PATIENTS

  • 1 January 1976
    • journal article
    • research article
    • Vol. 80  (3) , 297-305
Abstract
Teratomas were observed in 85 infants and children. Fifty-eight (68%) were girls and 27 (32%) boys. Site of origin was sacrococcygeal in 55 patients (64.8%), mediastinal in 10 (11.7%), gonadal in 10 (11.7%), presacral in 4 (4.8%), retroperitioneal in 3 (3.5%) and cervical in 3 (3.5%). Sixty-seven (78.8%) teratomas were benign and 18 (21.2%) were malignant. Malignant tumors were noted in 11 of 55 sacrococcygeal (20%), 2 of 10 mediastinal (20%), 3 of 8 ovarian (37.5%) and both testicular lesions. Cervical, retroperitoneal and presacral tumors were benign. Age at diagnosis (> 1 mo.), presence of symptoms (urinary and colonic obstruction) and serum positive for fetoprotein were indicators of malignancy in sacrococcygeal cases. Age was not a factor for teratomas at other sites. Tumor size, presence of calcification and gross appearance (cystic or solid) did not relate to the tumor''s benign or malignant nature. Three of 4 presacral tumors were associated with anorectal anomalies. Operative resection is the treatment of choice. Four deaths were related to operative hemorrhage. Four of 5 survivors with malignant teratoma received radiation and chemotherapy. A more agressive role for combined adjunctive measures is suggested in cases of malignancy.

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