Mixed Germ Cell with Immature Teratoma Element

Hi I am 38 years old and 4 weeks post surgery, I had a TAD and Salpingo-Oophorectomy, Omentemecomy for an Ovarian Mass.  

My Histology came back with the diagnosis as an Immature Teratoma, but when I questioned my surgeon he said that he said that it was not a pure one but had an immature teratoma in the middle of the mass and the outside was completely encapsulated with other germ cell components that contained skin, cartilage, fat, bone etc.

During the surgery he did serveral biopsies of all the surrounding peritoneal tissues and then a wash, all of the pathology for this and samples taken from my uterus, fallopian tube, omentum returned negative findings. So the only malignant part was the very centre of the primary tumour graded 2 and then 1a on the FIGO scale.

My Gyn/Onco has recommended that I have an Adjuviant course of Chemotherapy, now I have seen many of my friends and aquaintances go through chemo and it seriously frightens the hell out of me, it seems to me the treatment is nothing short of barbaric and people never seem to be the same upon completion.

I have been doing a lot of research on the internet, which really annoys my doctor, but I really think I need to be informed, as these tumours are quiet rare its very hard to find newer case histories and data, most of the stuff I have found is from the late 80's and 90's and I can't find anything about reoccurance rates where the paitent hasn't had chemo.

So I think that since the malignant part of my tumour was fully encapsulated, was resected with no spillage, all of my biospies and washings have returned a negative result, what the hell is it that they are planning to poison with chemo? I feel that it is only my healthy tissues!

I am sorry for the very involved post, but I guess I am looking for ladies that have had or have got the same or similar tumour with similar staging and am interested their experiences, Thanks in advance regards Bec              

[divelizard]

Really need spell check - ha, sorry for all the spelling mistakes, but I'm sure you be able to work it out. PS I had a Total Abdominal Hysterectomy not what ever the D stands for!

[kcd86]

So sorry to hear that you are dealing with so much at such a young age! There a varying forms of "Ovarian Germ Cell Tumors" most are benign but a few are malignant, to which some are a aggressive form. The decision to wait before any treatment should be discussed with your GYN/Oncologost. I hope you have a gyn/oncologist as your surgeon. Also I would advise that you go to a large cancer medical center i.e. Sloan Kettering in NYC as they deal with rare forms of gyn cancers much more frquently than most centers. I took my wife to Sloan as she also had a rare form of OVCA. Your gyn/oncologist based on the pathology report will be able to tell you how aggressive this immatre teratoms is.
Immature teratomas are the only ovarian germ cell tumor that are histologically graded. That is based on what they see under the microscope determines how aggressive they may be. The grade of aggressiveness (ranging from I [well differentiated] to III [poorly differentiated]) is based upon the proportion of tissue containing the immature elements . Tumor grade is an important indicator of the risk for spread ouside the ovary. The presence of foci of yolk sac tumor in immature teratomas generally reflects more aggressive tumor behavior.
It is very scary to think of the whole big picture at once  but the appropriate treatment will mean a currative course and a long life. Yes you can get infections after chemo but you will be told what to look out for to catch it early if you have to have chemo. The wait and see approach is very dangerous especially if you have an agreesive form of this cancer but again get to a large medical center and get their opinions.
I wish you all the best.
Good Luck
Kevin

Kevin