This approach requires close follow-up so that if the cancer comes back it can be found early and treated. Most women in this stage are cured with surgery and never need chemo. A grade 1 immature teratoma is made up mostly of non-cancerous tissue, and only a few cancerous areas are seen. These tumors rarely come back after being removed. If careful staging has determined that a grade 1 immature teratoma is limited to one or both ovaries, surgery to remove the ovary or ovaries containing the cancer and the fallopian tube or tubes might be the only treatment needed.
Recurrent tumors are those that come back after initial treatment. Persistent tumors are those that never disappeared even after treatment. Sometimes increased blood levels of the tumor markers HCG and AFP will be the only sign that a germ cell cancer is still there or has come back. Other times a definite tumor might be seen and removed by surgery. Treatment for recurrent or persistent germ cell tumors might include surgery, chemo or, rarely, radiation therapy.
Less commonly, it may spread to the lymph nodes , and metastasize to distant areas such as the lungs and liver through the bloodstream. Since this is a rare tumor, little research data is available compared to what we have for the much more common epithelial ovarian cancers. The specific drugs in these combinations, known as BEP when used together, are:. A second-line treatment, known as VAC, includes:.
Much of the information about this disease comes from experience in male patients with testicular cancer —however, the Gynecologic Oncology Group GOG has published a few smaller multicenter trials.
Follow-up after treatment for an immature teratoma is usually based on clinical exams, symptoms, and imaging tools like a CAT scan. What this means is that your doctor may order a scan if you have new symptoms or something is felt on examination. As of now, routine scans are not recommended, and there are no reliable tumor markers. The grade of the tumor is the single most important prognostic factor in early-stage disease—prognosis refers to a person's chance of recovery.
In other words, even if an immature teratoma is in an advanced stated, the grade is very important assuming all of visible cancer can be removed surgically. Across all stages, the five-year survival for grade 1 disease is approximately 82 percent and drops to approximately 30 percent when grade 3 disease is present. The five-year survival rate for stage 1 disease is 90 percent to 95 percent, while advanced stage survival drops to about 50 percent with Grade 1 to 2 cancer and to 25 percent or less when the tumors are found to be Grade 3.
A diagnosis of cancer is frightening at the same time that you are being called on to make major decisions about your own or your child's health. Here are some tips to help guide you through this difficult time:. Since this is an uncommon tumor, you probably don't have a support group in your community, but online cancer communities can often allow you to talk to many others who are facing this same rare disease. Keep in mind that the treatments for cancer are improving statistics are numbers that tell us how well someone did in the past, possibly before newer treatments were available.
Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones.
Sign up and get your guide! Int J Gynecol Cancer. Fertility sparing approach as the standard of care in young patients with immature teratomas. Maternal serum alpha-fetoprotein is a useful screening test for other fetal conditions, including Down syndrome , spina bifida , and abdominal wall defects such as gastroschisis. Regardless of location in the body, a teratoma is classified according to a cancer staging system.
This indicates whether chemotherapy or radiation therapy may be needed in addition to surgery. Teratomas commonly are classified using the Gonzalez-Crussi  grading system: 0 or mature benign ; 1 or immature, probably benign; 2 or immature, possibly malignant cancerous ; and 3 or frankly malignant. If frankly malignant, the tumor is a cancer for which additional cancer staging applies.
Teratomas are also classified by their content; a solid teratoma contains only tissues perhaps including more complex structures ; a cystic teratoma contains only pockets of fluid or semifluid such as cerebrospinal fluid , sebum , or fat; a mixed teratoma contains both solid and cystic parts. Cystic teratomas usually are grade 0 and, conversely, grade 0 teratomas usually are cystic.
Grades 0, 1, and 2 pure teratomas have the potential to become malignant grade 3 , and malignant pure teratomas have the potential to metastasize. These rare forms of teratoma with malignant transformation may contain elements of somatic not germ cell malignancy such as leukemia , carcinoma , or sarcoma. In infants and young children, these elements usually are endodermal sinus tumor , followed by choriocarcinoma.
Finally, a teratoma can be pure and not malignant yet highly aggressive; this is exemplified by growing teratoma syndrome, in which chemotherapy eliminates the malignant elements of a mixed tumor, leaving pure teratoma, which paradoxically begins to grow very rapidly. A "benign" grade 0 mature teratoma nonetheless has a risk of malignancy. Recurrence with malignant endodermal sinus tumor has been reported in cases of formerly benign mature teratoma,   even in fetiform teratoma and fetus in fetu.
It can be confused with other small round cell neoplasms such as neuroblastoma, small cell carcinoma of hypercalcemic type, primitive neuroectodermal tumor, Wilm's tumor, desmoplastic small round cell tumor, and non-Hodgkin lymphoma. A teratoma with malignant transformation is a very rare form of teratoma that may contain elements of somatic malignant tumors such as leukemia, carcinoma, or sarcoma.
Extraspinal ependymoma , usually considered to be a glioma a type of nongerm cell tumor , may be an unusual form of mature teratoma. The treatment of choice is complete surgical removal i. Exceptions include teratomas in the brain, and very large, complex teratomas that have pushed into and become interlaced with adjacent muscles and other structures.
Although often described as benign, a teratoma does have malignant potential. Five years after surgery, event-free survival was At 10 years after surgery, event-free and overall survival were Depending on which tissue s it contains, a teratoma may secrete a variety of chemicals with systemic effects.
This hormone is not recommended as a diagnostic marker, because most teratomas do not secrete it. Some teratomas secrete thyroxine , in some cases to such a degree that it can lead to clinical hyperthyroidism in the patient. Of special concern is the secretion of alpha-fetoprotein AFP ; under some circumstances, AFP can be used as a diagnostic marker specific for the presence of yolk sac cells within the teratoma.
These cells can develop into a frankly malignant tumor known as yolk sac tumor or endodermal sinus tumor. Embryonal teratomas most commonly occur in the sacrococcygeal region; sacrococcygeal teratoma is the single most common tumor found in newborn humans. Teratoma qualifies as a rare disease , but is not extremely rare.
Sacrococcygeal teratoma alone is diagnosed at birth in one out of 40, humans. Given the current human population and birth rate, this equals five per day or per year. Add to that number sacrococcygeal teratomas diagnosed later in life, and teratomas in other locales, and the incidence approaches 10, new diagnoses of teratoma per year. Ovarian teratomas have been reported in mares ,  mountain lions ,   and in canines. Pluripotent stem cells including human induced pluripotent stem cells have a unique property of being able to generate teratomas when injected in rodents in the research laboratory.
From Wikipedia, the free encyclopedia. Main article: Struma ovarii. Main article: Epignathus. Main article: Germ cell tumor. Access to Surgery: single best answer questions in general and systematic pathology. PasTest Ltd. Retrieved 20 December Ovarian Neoplasm Imaging. National Cancer Institute. Elsevier Health Sciences. Treatment of Cancer Fifth Edition. CRC Press. McGraw Hill Professional. Chapter Clinical Reproductive Medicine and Surgery.
The 5-minute Obstetrics and Gynecology Consult. Oncology: An Evidence-Based Approach. Case Reports in Pathology. Modern Pathology. International Journal of Gynecological Pathology. A study of two cases". Fetal Diagn. Can J Urol. Journal of Korean Medical Science. Archived from the original PDF on European Journal of Pediatric Surgery.
The Hounds (3) - The Lion Sleeps Tonight / I Like The Rhythm (Vinyl), Time - Lee Perry - The Return Of Sound System Scratch - More Lee Perry Dub Plate Mixes & Rarities 19, Ikudouon - Various - Sunrise Choir - Japan Rap & Beat (CD), If I Could Build My Whole World Around You - Marvin Gaye - The Marvin Gaye Collection (Box Set), Truth Between Errors Pt 2. - Truth Between Errors - Terminal Lovers - As Eyes Burn Clean (Vinyl, LP), I Like To Dance - Larry Graham & Graham Central Station* - By Popular Demand (CD), Under The Knife - Rise Against - The Sufferer & The Witness (CD, Album), Tall Girl - Dave Kriss - Emigrating (Vinyl, LP), Der Kleine Trompeter - Blank (2) - Long Live The People Of The Revolution (Vinyl, LP), II. Andantino Con Moto, Quasi Allegretto - Sibelius* / Philharmonia Orchestra, Paul Kletzki / David, Digital Bitch - Black Sabbath - Neon Bitches (CDr), In The Mirror - Various - Jens 303 (Vinyl), Heat Beat Starecase - Faith (Vinyl)