Pattern and outcome of childhood teratoma: a 10-year review.

Abstract

Background: Teratomas are neoplasms which originate from pluripotent stem cells. They are composed of a wide variety of tissues foreign to the organ or anatomic site in which they arose. This study sought to determine the clinical manifestations and outcome of treatment of childhood teratomas. Method: A retrospective analysis of the case files of children treated for teratoma at the University of Benin Teaching Hospital Benin City, Nigeria between January 1999 and December 2008 was done. Results: Fifty-three children aged between 5 days and 16 years, comprising 15 males and 38 females with male:female ratio of 2:5 were treated for teratoma; gonadal 27(50.9%) and extragonadal 26 (49.1%). Ovarian, 23 (43.4%) and sacrococcygeal, 17 (32.1%) sites were frequently involved. Other sites included testicular, 4 (7.5%), retroperitoneal, 4 (7.5%) and renal, 2 (3.8%), while posteriormediastinal, cervical and breast involvement were 1 (1.9%) each. Despite late presentation, no frankly malignant primary teratoma was diagnosed. Benign cystic teratomas with malignant elementscomprising yolk sac tumour and immature neuroepithelial elements (mixed germ cells tumour) were the major histological types. Complete tumour resection that included total coccygectomy, oophorectomyand orchidectomy, plus combination chemotherapy using vincristine, actinomycin, and cyclophosphamide was curative in 25 (47.2%) children. Eighteen (34%) cases of recurrence were all malignant. They presented very late with rapid disease progression that resulted in 10 (18.8%) deaths during the five years of follow-up. Conclusion: Although all primary teratoma were benign, recurrent malignant tumours with rapid progression to carcinomatosis, multiple organs failure and deaths were common in childhood teratoma. We advocate close follow-up of all children with teratoma to detect and commence early treatment.