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Isolated malignant elements may constitute a small fraction of a predominantly immature teratoma.
A clinical trial of surgery (unilateral salpingo-oophorectomy) followed by watchful waiting for stage I tumors that are not a dysgerminoma or immature teratoma.
Expression of NANOG by immature teratoma and choriocarcinoma is unknown.
All patients except those with stage I, grade I immature teratoma and stage IA dysgerminoma require postoperative chemotherapy.
For ovarian malignant GCT other than dysgerminomas or immature teratoma, treatment generally involves surgical resection and adjuvant chemotherapy.
A grade 1 immature teratoma that appears to be benign (e.g., because AFP is not elevated) has a much higher risk of malignancy, and requires adequate follow-up.
A mature teratoma is typically benign and found more commonly in women, while an immature teratoma is typically malignant and is more often found in men.
Complete resection of the coccyx is vital to minimize the likelihood of recurrent tumor;[10] however, one study reported that 11 out of 12 patients with microscopic residual benign immature teratoma had no recurrence.
Surgery alone was curative for most children and adolescents with resected ovarian immature teratoma of any grade, even when elevated levels of serum AFP or microscopic foci of yolk sac tumor were present.
In a series of 58 patients with immature teratoma treated before the modern chemotherapeutic era, recurrence was reported in 18% of the patients with grade 1 disease, in 37% of the patients with grade 2 disease, and in 70% of the patients with grade 3 disease.
For all patients with tumors other than pure dysgerminoma and low-grade (grade I) immature teratoma, chemotherapy is usually given postoperatively, although a series demonstrated excellent survival for patients with all types of stage I tumors managed by surveillance, reserving chemotherapy for cases in which postsurgery recurrence is documented.