Liu Shuhan,Wang Shan.Advances in the diagnosis and treatment of extracranial immature teratoma in children[J].Journal of Clinical Pediatric Surgery,,():684-688.[doi:10.3760/cma.j.cn101785-202505038]
Advances in the diagnosis and treatment of extracranial immature teratoma in children
- Keywords:
- Teratoma; Surgical Procedures; Operative; Child
- Abstract:
- Immature teratoma (IT) is a germ cell tumor of uncertain etiology,with diverse clinical manifestations.Its staging is consistent with that of malignant germ cell tumors,and grading is based on the Norris grading system.Extracranial IT in children is rare,and there is currently no unified standard treatment strategy worldwide.The main controversy lies in whether to adopt close postoperative surveillance or adjuvant chemotherapy.Studies from abroad suggest that close postoperative surveillance may replace adjuvant chemotherapy for tumors of any grade,whereas domestic studies propose that stratified chemotherapy based on patient-specific factors may help reduce the risk of tumor recurrence.Overall,the prognosis of pediatric extracranial IT is favorable,with an overall survival rate exceeding 95 %.Based on the existing literature,this review summarizes recent advances in the diagnosis,treatment,and prognosis of pediatric extracranial IT.
References:
[1] Heskett MB,Sanborn JZ,Boniface C,et al.Multiregion exome sequencing of ovarian immature teratomas reveals 2N near-diploid genomes,paucity of somatic mutations,and extensive allelic imbalances shared across mature,immature,and disseminated components[J].Mod Pathol,2020,33(6):1193-1206.DOI:10.1038/s41379-019-0446-y.
[2] Norris HJ,Zirkin HJ,Benson WL.Immature (malignant) teratoma of the ovary:a clinical and pathologic study of 58 cases[J].Cancer,1976,37(5):2359-2372.DOI:10.1002/1097-0142(197605)37:5<2359::aid-cncr2820370528>3.0.co;2-q.
[3] Pashankar F,Murray MJ,Gell J,et al.Consensus and controversy in the management of paediatric and adult patients with ovarian immature teratoma:the Malignant Germ Cell International Consortium perspective[J].EClinicalMedicine,2024,69:102453.DOI:10.1016/j.eclinm.2024.102453.
[4] 余婧,陈凯.儿童未成熟畸胎瘤的临床特征及诊治分析[J].现代诊断与治疗,2023,34(17):2532-2535,2542. Yu J,Chen K.Clinical features,diagnosis and treatment of immature teratoma in children[J].Mod Diagn Treat,2023,34(17):2532-2535,2542.
[5] Jiao H,Qiu YK,Huang WP,et al.Alpha-fetoprotein-elevated pos-tpubertal testicular teratoma with retroperitoneal metastasis on 18F-FDG PET/CT:case report and literature review[J].Front Med (Lausanne),2023,10:1269587.DOI:10.3389/fmed.2023.1269587.
[6] Saliyeva S,Boranbayeva R,Bulegenova M,et al.Outcomes of pediatric extracranial germ cell tumors:a single center experience in a developing country[J].Rare Tumors,2024,16:20363613231216567.DOI:10.1177/20363613231216567.
[7] Li SJ,Zhang XY,Zhang TY,et al.Prognostic factors for pure ovarian immature teratoma and the role of adjuvant chemotherapy in stage I diseases[J].Ann Med,2023,55(2):2273984.DOI:10.1080/07853890.2023.2273984.
[8] 张成航.儿童颅外转移性恶性生殖细胞肿瘤的临床特征及预后的单中心回顾性分析[D].重庆:重庆医科大学,2023.DOI:10.27674/d.cnki.gcyku.2023.002217. Zhang CH.A summary of single-center diagnosis and treatment experience of extracranial metastatic malignant germ cell tumor in children[D].Chongqing:Chongqing Medical University,2023.DOI:10.27674/d.cnki.gcyku.2023.002217.
[9] Bic? O,Ciongradi CI,Benchia D,et al.Assessment of molecular markers in pediatric ovarian tumors:Romanian single-center experience[J].Int J Mol Sci,2024,25(12):6752.DOI:10.3390/ijms25126752.
[10] Vieira AGS,Puthenpura V,Krailo M,et al.Adjuvant chemotherapy does not improve outcome in children with ovarian immature teratoma:a comparative analysis of clinical trial data from the Malignant Germ Cell International Consortium[J].Pediatr Blood Cancer,2023,70(8):e30426.DOI:10.1002/pbc.30426.
[11] Patel D,Tayade S,Sharma S,et al.Immature teratoma:a case report of a monster tumor in the pediatric age group[J].Cureus,2023,15(11):e48989.DOI:10.7759/cureus.48989.
[12] Moraru L,Mitranovici MI,Chiorean DM,et al.Immature teratoma:diagnosis and management-a review of the literature[J].Diagnostics (Basel),2023,13(9):1516.DOI:10.3390/diagnostics13091516.
[13] Ahmed G,Khalil SA,Elshafiey M,et al.Management strategy for children with ovarian immature teratoma:results from a tertiary pediatric oncology center[J].World J Surg Oncol,2024,22(1):176.DOI:10.1186/s12957-024-03452-z.
[14] 王珍妮,王珊,李长春,等.700例儿童颅外生殖细胞肿瘤单中心临床诊疗总结[J].中国小儿血液与肿瘤杂志,2023,28(4):231-236.DOI:10.3969/j.issn.1673-5323.2023.04.004. Wang ZN,Wang S,Li CC,et al.Summary of single-center clinical diagnosis and treatment of 700 cases of extracranial germ cell tumors in children[J].J China Pediatr Blood Cancer,2023,28(4):231-236.DOI:10.3969/j.issn.1673-5323.2023.04.004.
[15] Shinkai T,Masumoto K,Chiba F,et al.Pediatric ovarian immature teratoma:histological grading and clinical characteristics[J].J Pediatr Surg,2020,55(4):707-710.DOI:10.1016/j.jpedsurg.2019.04.037.
[16] Habib M,Khalil K,Tayyab Z,et al.Oncological outcomes of immature ovarian teratoma:a 15-year report from a cancer center[J].Cureus,2025,17(11):e95934.DOI:10.7759/cureus.95934.
[17] Bai BQ,Peng CH,Zheng Y,et al.Fetal sacrococcygeal immature teratoma:a case report and a literature review[J].BMC Pediatr,2025,25(1):822.DOI:10.1186/s12887-025-06031-7.
[18] 王安生,杜媛媛,杨阳.卵巢未成熟畸胎瘤的诊治进展[J].国际生殖健康/计划生育杂志,2021,40(6):524-528.DOI:10.12280/gjszjk.20210105. Wang AS,Du YY,Yang Y.Progress on diagnosis and treatment of ovarian immature teratoma[J].J Int Reprod Health Fam Plan,2021,40(6):524-528.DOI:10.12280/gjszjk.20210105.
[19] 茅君卿,李林洁,李民驹,等.儿童颅外恶性生殖细胞肿瘤诊治的国际研究进展[J].临床小儿外科杂志,2022,21(12):1134-1140.DOI:10.3760/cma.j.cn101785-202103017-007. Mao JQ,Li LJ,Li MJ,et al.Recent advances of diagnosing and treating malignant extracranial germ cell tumors in children[J].J Clin Ped Sur,2022,21(12):1134-1140.DOI:10.3760/cma.j.cn101785-202103017-007.
[20] Makino Y,Nakayama K,Sasaki Y,et al.Immature teratoma of uterine origin:a case report and literature review[J].Cureus,2025,17(7):e87765.DOI:10.7759/cureus.87765.
[21] Depani S,Stoneham S,Krailo M,et al.Results from the UK Children’s Cancer and Leukaemia Group study of extracranial germ cell tumours in children and adolescents (GCIII)[J].Eur J Cancer,2019,118:49-57.DOI:10.1016/j.ejca.2019.05.001.
[22] 中国抗癌协会小儿肿瘤专业委员会,中华医学会小儿外科分会肿瘤学组,中国研究型医院学会儿科肿瘤专业委员会.儿童颅外生殖细胞肿瘤诊疗专家共识(CCCG-GCTs-2021)[J].中国小儿血液与肿瘤杂志,2024,29(1):1-9,40.DOI:10.3969/j.issn.1673-5323.2024.01.001. Pediatric Oncology Professional Committee of China Anti Cancer Association,Oncology Group,Pediatric Surgery Branch,Chinese Medical Association,Pediatric Oncology Professional Committee of the Chinese Research Hospital Association.Expert consensus on the diagnosis and treatment of extracranial germ cell tumors in children (CCCG-GCTs-2021)[J].J China Pediatr Blood Cancer,2024,29(1):1-9,40.DOI:10.3969/j.issn.1673-5323.2024.01.001.
[23] 朱颖.卵巢未成熟畸胎瘤及其合并腹膜神经胶质瘤的临床分析[D].南昌:南昌大学,2022.DOI:10.27232/d.cnki.gnchu.2022.000422. Zhu Y.Clinical analysis of immature teratoma of ovary and its complicated peritoneal glioma[D].Nanchang:Nanchang University,2022.DOI:10.27232/d.cnki.gnchu.2022.000422.
[24] Hiester A,Nettersheim D,Nini A,et al.Management,treatment,and molecular background of the growing teratoma syndrome[J].Urol Clin North Am,2019,46(3):419-427.DOI:10.1016/j.ucl.2019.04.008.
[25] Nishino S,Nomura H,Goto T,et al.Recurrent immature teratoma mimicking growing teratoma syndrome following initial resection:a diagnostic pitfall[J].Case Rep Obstet Gynecol,2025,2025:4866935.DOI:10.1155/crog/4866935.
[26] Türkmen O,Akar Inan S,Akbay S,et al.Coexisting growing teratoma syndrome and gliomatosis peritonei following ovarian immature teratoma:a case report and literature review[J].Turk J Med Sci,2024,54(6):1192-1197.DOI:10.55730/1300-0144.5899.
[27] Bergamini A,Sarwar N,Ferrandina G,et al.Can we replace adjuvant chemotherapy with surveillance for stage IA-C immature ovarian teratomas of any grade? An international multicenter analysis[J].Eur J Cancer,2020,137:136-143.DOI:10.1016/j.ejca.2020.06.033.
[28] Cong LP,Wang SJ,Yeung SY,et al.Mature cystic teratoma:an integrated review[J].Int J Mol Sci,2023,24(7):6141.DOI:10.3390/ijms24076141.
[29] Maurac Pa?ali?I,Sabol M,Prtenja?a E,et al.Mature cystic teratoma and their malignant transformation[J].Eur J Surg Oncol,2025,51(4):109641.DOI:10.1016/j.ejso.2025.109641.
[30] Billod JA,Manangan-Wong RM.Malignant transformation in a mature cystic teratoma of the ovary:a 5-year descriptive study[J].Acta Med Philipp,2024,58(15):55-60.DOI:10.47895/amp.vi0.8023.
Memo
收稿日期:2025-5-23。
通讯作者:王珊,Email:wangshan778@163.com