Abstract

Fifteen patients with pure malignant immature teratoma of the ovary were treated at the Institut Gustave Roussy over a 17-year period. Chemotherapy was delivered as primary postoperative therapy in 11 patients. Four other patients received chemotherapy as part of their salvage treatment for recurrent disease. A second-look laparotomy was performed in eight patients. Histological findings were: no tumor in three patients, mature teratoma in four patients, and immature grade 1 teratoma in one patient. The latter five patients had persistent radiologic abnormalities at the end of chemotherapy. Twelve patients remain free of disease 24–228 months from initiation of chemotherapy. Two children were delivered from the two patients who attempted pregnancy. All three patients who died of progressive disease had a grade 3 immature teratoma. We conclude that the treatment of pure immature teratoma of the ovary should include primary conservative surgery and cisplatin-based chemotherapy. Second-look surgery is mandatory in patients with persistant radiologic abnormalities at the completion of chemotherapy.