We have recently diagnosed a special difficult case, immature teratoma.
Child, female, 9 years old. One week ago, the family found that the child's pelvic cavity was slightly bulged, and it was hard to touch. There was no tenderness. No specific treatment was performed. After observation, the pelvic cavity gradually bulged a mass. It is recommended to come to our hospital for further diagnosis and treatment. Outpatient color Doppler ultrasound shows: a huge cystic solid mass in the pelvic cavity. Considering teratoma (mostly from the posterior pelvic peritoneal iliac crest), hospitalization is recommended. As seen during the operation, the mass originated from the right ovary, and the malignancy was considered in combination with the naked eye and intraoperative freezing results. The last lump was removed. General view: one gray-red cystic solid mass, with a total volume of 13.5cm ¡Á 11cm ¡Á 6.5cm, the section is multi-colored, and the solid area is the main area. There are multiple cysts, and the diameter of the cysts is 1.8-3cm. Contains a gray-red liquid, of varying quality, with bone tissue. Pathological diagnosis: (right ovary) immature teratoma grade Ⅱ-Ⅲ, no invasion of the capsule.
Immature teratoma mostly occurs before the age of 20, less than 10% of patients over the age of 30, and rare after menopause. The tumor grows rapidly and manifests as an abdominal mass or torsion of the tumor and abdominal pain. In some patients, serum AFP is slightly elevated and occasionally hCG is elevated. About one-third of the patients had extraovarian spread at the time of surgery, usually manifested as peritoneal implants, a few lymph node metastases, and rare hematogenous metastases. Tumor classification and staging are important prognostic factors. Survival rates for tumor grades 1, 2, and 3 are 82%, 63%, and 30% for surgery alone, and increased to 90% -100% after combined chemotherapy. Some studies have shown that the prognosis of immature teratomas in children and adolescents is good. The recurrence of immature teratomas in this age group is likely to be related to the yolk sac component, which should be treated with chemotherapy.
Department of Pathology