Abstract
Fifty-four pediatric patients with teratoma group tumors have been treated at our institute during last 20 years. Differential diagnosis of teratomas by the echography, CT scan and angiography is discussed in this paper The results of operation and chemotherapy for immature and malignant teratomas, especially ovarian, sacrococcygeal and retroperitoneal teratomas are presented. There were 36 patients with benign mature teratoma (Tm) , 8 with immature teratoma and 10 with malignant teratoma. The result of treatment for mature teratoma was good from 1 to 20 years after the removal of tumors. Fourteen of 18 patients with immature and malignant teratoma are doing well from 10 months to 17 years after the removal of tumors with/without the chemotherapy and/or radiation. The histologic type was : immature teratoma (Ti) 8, dysgerminoma (Dys) 4, embryonal carcinoma (EC) 3 and yolk sack tumor (YST) 3. The primary sites were : ovarian 8, sacrococcygeal 7, retroperitoneal 1, mediastin al 1 and testicular 1. Ovarian immature and malignant teratoma : Good re sponses were obtained by VAC therapy for stage III Ti high dose cyclophosphamide (HD-CPA) therapy for stage III Dys, HD-CPA and radiation for stage IV Dys, radiation for stage III Dys, low dose CPA therapy for stage I Dys, T2 protocol for stage I EC, after salpingo-oophorectomy. Sacrococcygeal : Three patients with Ti survive after the complete reseciton without chemotherapy, but 2 patients have had problems related to the urinary system. Preoperative PVB therapy and second look operation for stage IV YST have been successful. Retroperitoneal : One stage II Ti case is uneventful after the complete removal of tumor without chemotherapy. One Tm patient had the recurrence of the mature neural component 14 years later at the same site as the previous lesion with several peritoneal disseminative nodules. The patient has been on a good condition without chemotherapy after the second resection.
