Articles on immature teratoma for bmcd (Bob) (and your daughter)

[GlendaS]

Here is some more info on immature teratoma that may be helpful. This was taken from the website ncbi.nlm.nih.gov. You can do a search in the pubmed section and it will bring up many articles on immature teratoma

Surgical resection alone is effective treatment for ovarian immature teratoma in children and adolescents: a report of the pediatric oncology group and the children's cancer group.Cushing B, Giller R, Ablin A, Cohen L, Cullen J, Hawkins E, Heifetz SA, Krailo M, Lauer SJ, Marina N, Rao PV, Rescorla F, Vinocur CD, Weetman RM, Castleberry RP.
Children's Hospital of Michigan, Detroit, USA.

OBJECTIVE: In both adult women and children the potential for malignant recurrence from ovarian immature teratoma has prompted the standard use of chemotherapy after complete resection of the primary tumor. The efficacy of postoperative chemotherapy in children and adolescents with ovarian immature teratoma, however, has not been established. A pediatric intergroup trial (INT 0106) was designed to determine the need for postoperative chemotherapy in patients with ovarian immature teratoma after management with surgical resection only.Study Design: Between 1990 and 1995, 44 patients with completely resected ovarian immature tumor and without postoperative chemotherapy, who were able to undergo assessment, were accrued. Tumor tissue was evaluated by central pathology review to confirm diagnosis and determine tumor grading of immature neural elements. Patients were followed carefully for recurrence of disease with appropriate diagnostic imaging and serum marker studies.

[GlendaS]

Ran out of space...here's the rest of the article.....

RESULTS: Thirty-one patients had pure ovarian immature teratoma with a tumor grade of 1 (n = 17), 2 (n = 12), or 3 (n = 2). Age at diagnosis ranged between 1.5 and 15 years (median, 10). Of the 29 patients studied, the serum alpha-fetoprotein level was elevated in 10 (34%); the median level was 25 ng/ml. Thirteen patients had ovarian immature teratoma plus microscopic foci of yolk sac tumor. Tumor grade was 1, 2, or 3 in 1, 6, and 6 patients, respectively. Age ranged between 6 and 20 years (median, 12). In the 12 patients evaluated for serum alpha-fetoprotein, 10 (83%) had elevated levels; the median level was 262 ng/ml. The 4-year event-free and overall survival for the ovarian immature teratoma group and for the ovarian immature teratoma plus yolk sac tumor group was 97.7% (95% confidence interval, 84.9%-99.7%) and 100%, respectively. The only yolk sac tumor relapse occurred in a child with ovarian immature teratoma and yolk sac tumor who was then treated with chemotherapy and is alive and free of disease 57 months after recurrence. CONCLUSION: The results of this study suggest that surgery alone is curative for most children and adolescents with resected ovarian immature teratoma of any grade, even when elevated levels of serum alpha-fetoprotein or microscopic foci of yolk sac tumor are present. This experience strongly supports avoiding the long-term effects of chemotherapy in most children with ovarian immature teratoma by reserving postoperative therapy for cases with relapse.

[GlendaS]

Here is another article found on a blackwell-synergy.com search.
Immature ovarian teratoma in a young girl: very short course and lethal outcome. A case report
M. Terzic**Department of Obstetrics and Gynecology, M. Dokic**Department of Obstetrics and Gynecology & B. Stimec††Institute for Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia and Montenegro*Department of Obstetrics and Gynecology and †Institute for Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia and Montenegro
Abstract

Abstract.  
Terzic M, Dokic M, Stimec B. Immature ovarian teratoma in a young girl: very short course and lethal outcome. A case report. Int J Gynecol Cancer 2005;15:382–384.

Immature teratomas of the ovary represent less than 1% of all ovarian teratomas. They contain several tissues that derive from the three embryologic layers: ectoderm, mesoderm, and endoderm. We report the case of a 17-year-old girl who presented with an immature teratoma of the left ovary that recurred 3 months later as an inoperable malignant neuroepithelial peritoneal tumor resembling a glioblastoma. She died 3 weeks after the second explorative operation. The very aggressive course and fast lethal outcome could be explained by the patient's refusal to receive chemotherapy after the initial operation.

[GlendaS]

Another article that can be found on greenjournal.org search.
Pure ovarian immature teratoma, a unique and curable disease: 10 years' experience of 32 prospectively treated patients
C Bonazzi, F Peccatori, N Colombo, V Lucchini, MG Cantu, and C Mangioni


OBJECTIVE: To report and evaluate a conservative and individualized treatment policy in a homogeneously selected series of patients affected by pure ovarian immature teratoma. METHODS: This prospective trial, with specific treatment policies according to stage and grade, was planned and started in 1982. The study population consisted of 32 patients affected by pure immature teratoma, with the exclusion of mixed germ cell tumors. Fertility-sparing surgery was performed whenever possible. Surgery alone, with careful follow-up, was adopted for stage I or II according to the International Federation of Gynecology and Obstetrics (FIGO) and grade 1 or 2 tumors. The other patients, with stage III or with grade 3 stage I or II tumors, or those referred at relapse, were treated with platinum-based chemotherapy regimens. RESULTS: Thirty of 32 patients underwent fertility-sparing surgery. Ten of 32 patients received chemotherapy after surgery, either as adjuvant treatment or in the presence of visible tumor. All 32 patients are alive and disease-free, with a median follow-up from surgery of 47 months (range 11-138). In six patients, regardless of the administration of chemotherapy, the tumor either spontaneously differentiated toward mature glia or increased in volume, mimicking progression but still remaining completely mature. Five of six patients wishing to procreate had a total of seven normal pregnancies. CONCLUSIONS: Pure ovarian immature teratoma is a potentially curable disease with a unique natural history. Our data substantiate the hypothesis that low-grade and low-stage tumors do not require chemotherapy, and that a fertility-sparing surgical approach is warranted in all cases.

[GlendaS]

Another article on greenjournal.org

Surgical management of malignant ovarian germ-cell tumors: 10 years' experience of 129 patients
F Peccatori, C Bonazzi, S Chiari, F Landoni, N Colombo, and C Mangioni


OBJECTIVE: To evaluate the surgical management of ovarian germ-cell tumors treated at a single institution during the last decade. METHODS: One hundred twenty-nine patients affected by ovarian germ-cell tumors were studied retrospectively for their surgical management. Fifty-seven patients were affected by dysgerminoma, 39 by non-dysgerminoma, and 33 by pure immature teratoma. Seventy-nine patients were stage I according to International Federation of Gynecology and Obstetrics criteria, with five first referred at recurrence, 11 at stage II, 35 at stage III, and four at stage IV. RESULTS: Fertility-sparing surgery was performed in 108 of 129 patients. Eighty-five of 100 referred patients underwent surgical or radiologic restaging, with an increase in staging in 16 cases. Three patients with immature teratoma underwent second laparotomy for a growing mass. Thirty-one patients underwent second-look surgery, with positive findings in four cases. Three patients did not respond to chemotherapy, and ten had a recurrence after complete response or surveillance. Six patients died of tumor, with an overall survival of 96% (mean follow-up time 55 months). CONCLUSION: Fertility-sparing surgery is warranted in all ovarian germ-cell tumors because it does not affect recurrence rate or survival. Extensive tumor-reductive surgery is advisable only in immature teratoma patients and is not necessary for other histologic types. Restaging can be useful in selected cases, but the administration of effective chemotherapy, when needed, seems to be more important. The usefulness of second-look surgery is marginal

And another from greenjournal.org:

Pregnancy following conservative surgery and adjunctive chemotherapy for stage III immature teratoma of the ovary
RB Lee, J Kelly, SA Elg, and WL Benson


A 24-year-old woman with stage III grade 3 immature teratoma of the ovary was treated with a unilateral salpingo-oophorectomy and nine courses of vincristine, actinomycin D, and cyclophosphamide combination chemotherapy. She had a negative second-look exploration; 30 months after initial surgery she became pregnant, and subsequently delivered a normal child at term. This is the first report of a successful pregnancy following conservative surgery and chemotherapy for advanced-stage immature teratoma.

And another:

ORIGINAL RESEARCH


Growing Teratoma Syndrome After Ovarian Germ Cell Tumors
Livia Zagamé, MD1, Patricia Pautier, MD1, Pierre Duvillard, MD2, Damienne Castaigne, MD3, Catherine Patte, MD4 and Catherine Lhommé, MD1
From the 1Medical Oncologic Department, the 2Pathologic Unit, the 3Surgical Department, and the 4Pediatric Department, Institut Gustave-Roussy, Villejuif, France.

OBJECTIVE: To analyze a series of occurrences of growing teratoma syndrome after ovarian germ cell tumors.

METHODS: We analyzed a database containing 103 patients affected by pure or mixed ovarian immature teratoma.

RESULTS: We report 12 patients fulfilling growing teratoma syndrome criteria (incidence 12%). The median interval between the diagnosis of ovarian immature teratoma and growing teratoma syndrome was 9 months (range 4–55). Growing teratoma syndrome was revealed by radiological examinations in nine cases (75%). In all cases but one, growing teratoma syndrome occurred in the site involved by the primary tumor. The peritoneum was the first site involved (10 cases, 83%). A complete surgical resection of the growing teratoma syndrome was done in eight cases. The median follow-up was 144 months. Four patients presented a late growing teratoma syndrome recurrence after treatment (second event), more than 5 years after the initial diagnosis, and 14 years later for one patient. All patients but one (lost to follow-up) were still alive at the end of the study.

CONCLUSION: The treatment of growing teratoma syndrome consists of the surgical resection of the tumor, as completely as possible. Because of the possibility of very late recurrence of growing teratoma syndrome, a prolonged follow-up of patients treated for ovarian immature teratoma is mandatory.

LEVEL OF EVIDENCE: II-3


I hope these help....you can find many more if you do searches on these websites I listed....

[bmcd]

Thanks a million for all the research and articles.  And thanks to everyone who is praying for my daughter.  It really means the world to me and helps me through each day.

Thanks again,
Bob