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Ovarian teratoma is a type of germ cell tumour. Germ cell tumours are cancers that begin in egg cells in women or sperm cells in men. There are two main types of ovarian teratoma
Mature teratoma, which is benign
Immature teratoma, which is cancerous
The mature teratoma is the most common type of ovarian germ cell tumour. It is most often diagnosed in women during their reproductive years (from teens to forties).
Mature teratoma is often called a dermoid cyst. It is removed with surgery and the condition is then cured.
Immature teratomas are usually diagnosed in girls and young women, often younger than 18. These cancers are rare. They are called 'immature' because the cancer cells are at a very early stage of development. Most immature teratomas of the ovary are cured, even if they are diagnosed at an advanced stage.
Grading and staging ovarian teratoma
The grade and stage of your cancer is very important because they help your specialist to decide what treatment you need. The grade describes how the cells look under the microscope. The more under-developed the cells look, the higher the grade. Higher grade cancers grow more quickly than low grade. There are 3 different grades of immature teratoma. Generally, grade 1 teratomas are the slowest growing and least likely to spread.
The stage of a cancer tells you how far it has grown. In ovarian teratoma
Stage 1 means the cancer is only in the ovary (or both ovaries)
Stage 2 means the cancer has spread into the fallopian tube, womb, or elsewhere in the pelvis (the pelvis is the area circled by your hip bones)
Stage 3 means the cancer has spread to the lymph nodes or to the tissues lining the abdomen (called the peritoneum)
Stage 4 means the cancer has spread to another body organ some distance away, for example, the lungs
Treating ovarian teratoma
Surgery and chemotherapy are the treatments most often used for immature teratoma of the ovary.
During your surgery, the affected ovary will be removed but your other ovary will be left. The surgeon examines the inside of your abdomen and your abdominal organs for signs of cancer. Biopsies may be taken and sent to the lab to look for cancer cells. The surgeon will also wash out the inside of your abdomen and send the fluid to the lab to be checked for cancer cells. This is all done to make absolutely sure that the cancer hasn't spread.
If you have a grade 1 immature teratoma that has not spread outside the ovary (stage 1) then surgery is likely to cure it and you may not need chemotherapy.
If the cancer has spread beyond the ovary, your surgeon will remove as much of the teratoma as possible. Chemotherapy is usually given after surgery. Immature teratomas of the ovary can often be cured with a combination of surgery and chemotherapy, even if they have spread when they are diagnosed.
Your exact treatment programme has to be decided by your own specialist, but the most common combination of drugs used is BEP, that is bleomycin, etoposide and cisplatin. This combination is used because it is very effective at preventing the teratoma from coming back. And because it is less likely to cause infertility than some other combinations of chemotherapy drugs. The chemotherapy is usually given as several cycles of treatment. Each cycle lasts about 3 weeks with several days of chemotherapy given at the beginning of the cycle. There is most information about how chemotherapy is planned and given in the chemotherapy section of CancerHelp UK.
After you have finished your treatment, your specialist will see you regularly. When you were first diagnosed, you will have had blood tests that may have shown up chemicals released by the cancer cells. These are called markers. The markers produced by most immature teratomas are called HCG and AFP. Not everyone with a teratoma has raised markers. But if you did when you were diagnosed, your specialist can use them to monitor your health at your follow up appointments.
You will have blood tests regularly to check for these markers. If they are found in your blood, this could indicate that the cancer has come back. There is more information about these markers in the testicular cancer section of CancerHelp UK, because teratoma is a tumour most often diagnosed in men. At your follow up appointments, your specialist will also examine you and ask how you are feeling. You may have CT scans from time to time, but not everyone needs these and your specialist will talk you through your follow up in more detail.
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