Treatment and prognosis of immature teratoma

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If you have been told that you have an immature teratoma, you are probably very scared. This not only means cancer, but these tumors are usually found at a very young age.

What exactly is this type of germ cell tumor and how is it treated?

Eric Odras / Getty Images

Overview

Immature teratomas are made up of tissue that resembles that of the embryo. They are malignant relatives of the very common mature cystic teratomas or dermoid cysts. When immature teratomas occur in combination with other germ cell tumors, they are called "mixed germ cell tumors."

Pure immature teratoma is extremely rare, accounting for about 1 percent of all ovarian cancers, but it is the second most common malignant tumor in the group of germ cell tumors .

Age of women with immature teratomas

In women younger than 20 years, these tumors account for 10 to 20 percent of all ovarian malignancies. About half of all immature teratomas can occur even earlier, between the ages of 10 and 20. They rarely occur in postmenopausal women .

Watch out

Treatment for an immature teratoma includes surgery and chemotherapy. Patients with stage 1 immature Ia teratoma are generally treated with surgery only because the prognosis is excellent. When the tumor has progressed to grade 2 or 3, or is beyond stage Ia, chemotherapy is generally recommended.

Immature teratoma grade refers to the portion of tissue that contains immature nerve elements (resembling fetal organs). For example, according to the American Cancer Society , grade 1 immature teratoma consists mainly of benign tissue and only a few areas of cancerous tissue that can be seen under a microscope. The stage of an immature teratoma means how far it has spread; A stage I tumor means that its growth is restricted to the ovaries.

Surgery

In women of reproductive age who wish to maintain fertility, removal of the affected ovary and surgical stage can be performed, leaving only the uterus and the other ovary. This can be done because the other ovary is rarely affected, but staging is still required to make sure the cancer has not spread.

When it spreads, it generally occurs in the same way as with epithelial ovarian cancer: in and around the organs within the abdominal cavity. Less commonly, it can spread to the lymph nodes and metastasize to distant areas such as the lungs and liver through the bloodstream .

Chemotherapy

Because it is a rare tumor, there is little research data available compared to what we have for the much more common epithelial ovarian cancer.

The specific drugs in these combinations, known as BEP when used together:

  • Bleomycin
  • Etoposide
  • Cisplatin

Second-line treatments, known as VAC, include:

  • Vincristine
  • Adriamycin
  • Cyclophosphamide

Much of the information about this disease comes from the experience of male patients with testicular cancer ; however, the Gynecologic Oncology Group (GOG) has published several small multicenter studies. BEP is currently the recommended initial treatment in most cases. cases, but VAC mode can also be used, especially in relapses.

Follow-up after treatment

Follow-up after treatment for immature teratoma is generally based on clinical investigations, symptoms, and imaging instruments such as computed tomography. This means that your healthcare provider can schedule a scan if you develop new symptoms or feel something on the exam. Routine examination is not recommended at this time and there are no reliable tumor markers.

Forecast

The extent of the tumor is the most important predictor in the early stage of the disease; prognosis refers to a person's chances of recovery. In other words, even if the immature teratoma is in an advanced stage, the grade is very important (as long as all visible cancers can be surgically removed).

In all stages, the five-year survival rate for grade 1 disease is approximately 82 percent and falls to approximately 30 percent for grade 3 disease. The five-year survival rate for disease in Stage 1 is 90 to 95 percent, while the survival rate for advanced stages drops to about 50 percent for grade 1-2 cancer and 25 percent or less for grade 3 cancer.

How to deal with the diagnosis

Being diagnosed with cancer is scary at the same time that you have to make important decisions about your own health or the health of your child. Here are some tips to help you through this difficult time:

  • Asking a lot of questions.
  • Consider getting a second opinion.
  • Find out all you can about your diagnosis; This appears to have benefits that not only keep you informed, but can also affect your prognosis.
  • Ask your PCP about clinical trials.
  • Find out what you can do to maintain fertility in cancer .

Since this is a rare tumor, you probably don't have a support group in your community, but online cancer communities can often allow you to speak to many other people dealing with this same rare disease.

Keep in mind that cancer treatments are improving (statistics are numbers that tell us how well someone has done in the past, perhaps before new treatments were available). Learn how to protect yourself or your child as a cancer patient so you can feel empowered on your journey.

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