Mature and immature teratoma: A report from the second Italian pediatric study

Monica Terenziani, Paolo D'Angelo, Alessandro Inserra, Renata Boldrini, Gianni Bisogno, Gian Luca Babbo, Massimo Conte, Patrizia Dall' Igna, Maria Debora De Pasquale, Paolo Indolfi, Luigi Piva, Giovanna Riccipetitoni, Fortunato Siracusa, Filippo Spreafico, Paolo Tamaro, Giovanni Cecchetto

Research output: Contribution to journalArticle

Abstract

Background: Teratomas demonstrate a benign clinical behavior, however they may recur with malignant components or as teratoma, and in a small group of patients prognosis could be fatal. After the first Italian study, we collected cases of teratoma, alongside the protocol for malignant germ cell tumors. Procedure: Patients with teratoma were collected from 2004 to 2014. Teratomas were classified according to the WHO classifications, as mature and immature. Patients with pathological aFP and/or bHCG, and those with a malignant germ cell component were not included. Results: The study enrolled 219 patients (150 mature, 69 immature teratomas) with a median age at diagnosis of 42 months. The primary sites involved were: 118 gonadal and 101 extragonadal teratomas. Two females with ovarian teratoma had a positive family history. Complete and incomplete surgeries were performed in 85% and 9% of cases. Seventeen events occurred: six females had a second metachronous tumor (5 contralateral ovarian teratoma, 1 adrenal neuroblastoma) and 11 teratomas relapsed/progressed (3 mature, 8 immature teratomas). Two patients died, one of progressive immature teratoma and one of surgical complications. At a median follow up of 68 months, the event-free, relapse-free, and overall survival rates were 90.6%, 94.3%, 98.6%, respectively. Conclusions: Teratomas show a good prognosis, especially the mature ones: surgery and follow-up remain the standard approach. Incomplete surgery in immature teratoma is the group at greatest risk of relapse. Bilateral ovarian tumors are a possibility, and the rare family predisposition to ovarian mature teratoma warrants further analyses. Pediatr Blood Cancer 2015;62:1202-1208.

Original languageEnglish
Pages (from-to)1202-1208
Number of pages7
JournalPediatric Blood and Cancer
Volume62
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

Fingerprint

Teratoma
Pediatrics
Recurrence
Neoplasms
Germ Cell and Embryonal Neoplasms
Cellular Structures
Neuroblastoma
Germ Cells
Survival Rate

Keywords

  • Childhood
  • Germ cell tumors
  • Immature teratoma
  • Mature teratoma

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Medicine(all)

Cite this

Mature and immature teratoma : A report from the second Italian pediatric study. / Terenziani, Monica; D'Angelo, Paolo; Inserra, Alessandro; Boldrini, Renata; Bisogno, Gianni; Babbo, Gian Luca; Conte, Massimo; Dall' Igna, Patrizia; De Pasquale, Maria Debora; Indolfi, Paolo; Piva, Luigi; Riccipetitoni, Giovanna; Siracusa, Fortunato; Spreafico, Filippo; Tamaro, Paolo; Cecchetto, Giovanni.

In: Pediatric Blood and Cancer, Vol. 62, No. 7, 01.07.2015, p. 1202-1208.

Research output: Contribution to journalArticle

Terenziani, M, D'Angelo, P, Inserra, A, Boldrini, R, Bisogno, G, Babbo, GL, Conte, M, Dall' Igna, P, De Pasquale, MD, Indolfi, P, Piva, L, Riccipetitoni, G, Siracusa, F, Spreafico, F, Tamaro, P & Cecchetto, G 2015, 'Mature and immature teratoma: A report from the second Italian pediatric study', Pediatric Blood and Cancer, vol. 62, no. 7, pp. 1202-1208. https://doi.org/10.1002/pbc.25423
Terenziani, Monica ; D'Angelo, Paolo ; Inserra, Alessandro ; Boldrini, Renata ; Bisogno, Gianni ; Babbo, Gian Luca ; Conte, Massimo ; Dall' Igna, Patrizia ; De Pasquale, Maria Debora ; Indolfi, Paolo ; Piva, Luigi ; Riccipetitoni, Giovanna ; Siracusa, Fortunato ; Spreafico, Filippo ; Tamaro, Paolo ; Cecchetto, Giovanni. / Mature and immature teratoma : A report from the second Italian pediatric study. In: Pediatric Blood and Cancer. 2015 ; Vol. 62, No. 7. pp. 1202-1208.
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abstract = "Background: Teratomas demonstrate a benign clinical behavior, however they may recur with malignant components or as teratoma, and in a small group of patients prognosis could be fatal. After the first Italian study, we collected cases of teratoma, alongside the protocol for malignant germ cell tumors. Procedure: Patients with teratoma were collected from 2004 to 2014. Teratomas were classified according to the WHO classifications, as mature and immature. Patients with pathological aFP and/or bHCG, and those with a malignant germ cell component were not included. Results: The study enrolled 219 patients (150 mature, 69 immature teratomas) with a median age at diagnosis of 42 months. The primary sites involved were: 118 gonadal and 101 extragonadal teratomas. Two females with ovarian teratoma had a positive family history. Complete and incomplete surgeries were performed in 85{\%} and 9{\%} of cases. Seventeen events occurred: six females had a second metachronous tumor (5 contralateral ovarian teratoma, 1 adrenal neuroblastoma) and 11 teratomas relapsed/progressed (3 mature, 8 immature teratomas). Two patients died, one of progressive immature teratoma and one of surgical complications. At a median follow up of 68 months, the event-free, relapse-free, and overall survival rates were 90.6{\%}, 94.3{\%}, 98.6{\%}, respectively. Conclusions: Teratomas show a good prognosis, especially the mature ones: surgery and follow-up remain the standard approach. Incomplete surgery in immature teratoma is the group at greatest risk of relapse. Bilateral ovarian tumors are a possibility, and the rare family predisposition to ovarian mature teratoma warrants further analyses. Pediatr Blood Cancer 2015;62:1202-1208.",
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AU - Inserra, Alessandro

AU - Boldrini, Renata

AU - Bisogno, Gianni

AU - Babbo, Gian Luca

AU - Conte, Massimo

AU - Dall' Igna, Patrizia

AU - De Pasquale, Maria Debora

AU - Indolfi, Paolo

AU - Piva, Luigi

AU - Riccipetitoni, Giovanna

AU - Siracusa, Fortunato

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AU - Cecchetto, Giovanni

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N2 - Background: Teratomas demonstrate a benign clinical behavior, however they may recur with malignant components or as teratoma, and in a small group of patients prognosis could be fatal. After the first Italian study, we collected cases of teratoma, alongside the protocol for malignant germ cell tumors. Procedure: Patients with teratoma were collected from 2004 to 2014. Teratomas were classified according to the WHO classifications, as mature and immature. Patients with pathological aFP and/or bHCG, and those with a malignant germ cell component were not included. Results: The study enrolled 219 patients (150 mature, 69 immature teratomas) with a median age at diagnosis of 42 months. The primary sites involved were: 118 gonadal and 101 extragonadal teratomas. Two females with ovarian teratoma had a positive family history. Complete and incomplete surgeries were performed in 85% and 9% of cases. Seventeen events occurred: six females had a second metachronous tumor (5 contralateral ovarian teratoma, 1 adrenal neuroblastoma) and 11 teratomas relapsed/progressed (3 mature, 8 immature teratomas). Two patients died, one of progressive immature teratoma and one of surgical complications. At a median follow up of 68 months, the event-free, relapse-free, and overall survival rates were 90.6%, 94.3%, 98.6%, respectively. Conclusions: Teratomas show a good prognosis, especially the mature ones: surgery and follow-up remain the standard approach. Incomplete surgery in immature teratoma is the group at greatest risk of relapse. Bilateral ovarian tumors are a possibility, and the rare family predisposition to ovarian mature teratoma warrants further analyses. Pediatr Blood Cancer 2015;62:1202-1208.

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