Pure pediatric ovarian immature teratomas: The French experience

Pediatr Blood Cancer. 2020 Apr;67(4):e28186. doi: 10.1002/pbc.28186. Epub 2020 Jan 25.


Objective: To describe characteristics and outcome of pediatric ovarian immature teratomas (IT) to better define the place of chemotherapy.

Methods: Children with ovarian IT enrolled in TGM95 and TGM2013 studies were analyzed. Norris grading and International Federation of Gynecology and Obstetrics staging system were used.

Results: Thirty-six cases were identified with a median age of 11 years (range = 1-18): 35 of 36 stage I (17 stage IA, 13 stage IC, and 5 stage IX), including seven patients with gliomatosis peritonei (GP), and 1 stage IIIB (IT peritoneal implants). Centrally reviewed Norris grading was performed in 31 cases: 14 grade I and 17 grade II/III tumors. All patients underwent upfront surgery: 19 unilateral oophorectomy, 14 unilateral adnexectomy, 2 unilateral cystectomy, and 1 bilateral cystectomy. No extensive GP surgery was performed. Six patients received adjuvant vinblastin, bleomycin, and cisplatinum because of tumor rupture (n = 5, including two patients with GP) or stage III (n = 1). After a median follow-up of 39.5 months (range = 6-238), two events occurred 10 and 11 months after diagnosis: one bilateralization (initial stage IX, grade I) and one IT peritoneal relapse (initial stage IA, grade II), respectively. Both were successfully rescued by platinum-based chemotherapy and delayed surgery. No stage IC patients treated without adjuvant chemotherapy relapsed (four grade I and three grade III). None of the seven patients with GP progressed. Five-year event-free survival and overall survival were 94% (95% CI = 81-98%) and 100%.

Conclusions: The current series confirms the excellent prognosis of pediatric ovarian IT, arguing for conservative surgical approach in GP and against systematic adjuvant chemotherapy, even in ruptured tumors.

Keywords: chemotherapy; children; immature teratomas; ovary; prognosis; rupture.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Bleomycin / administration & dosage
  • Child
  • Child, Preschool
  • Cisplatin / administration & dosage
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • France
  • Humans
  • Infant
  • Neoplasm Grading
  • Ovarian Neoplasms* / mortality
  • Ovarian Neoplasms* / therapy
  • Ovariectomy*
  • Survival Rate
  • Teratoma* / mortality
  • Teratoma* / therapy
  • Vinblastine / administration & dosage


  • Bleomycin
  • Vinblastine
  • Cisplatin