Do early stage malignant teratomas need chemotherapy?

Teratomas are tumors derived from germ cells with multidirectional differentiation potential, often containing a variety of tissue components from the three germ layers, with disordered arrangement structures. According to their appearance, they can be divided into cystic and solid types; according to the degree of differentiation and maturity of their tissues, they can be divided into benign teratomas and malignant teratomas. The following will introduce in detail whether chemotherapy is required for early malignant teratomas?

Whether teratoma needs chemotherapy depends on the severity of the teratoma.

Once a teratoma is diagnosed, early surgical resection is necessary to prevent benign teratoma from becoming malignant due to delayed surgery, and to prevent infection, rupture, bleeding and complications. The key point of teratoma surgery is to completely remove the tumor. For ovarian and testicular tumors, one ovary or testicle should be removed. For sacrococcygeal teratoma, the coccyx must be removed at the same time to avoid residual pluripotent cells that may cause tumor recurrence.

The treatment principle of malignant teratoma is combined adjuvant therapy. Conventional chemotherapy is used for 1.5 to 2 years after surgical resection. Cisplatin, vinblastine or vincristine, and bleomycin are commonly used. In recent years, combined chemotherapy with cisplatin, doxorubicin, ifosfamide and other chemotherapy drugs is recommended. Radiotherapy is only used for cases of malignant teratoma with clear microscopic or macroscopic residuals. The radiotherapy dose is preferably 25Gy for microscopic residuals, and 35Gy for macroscopic residuals. For those with complete surgical resection, chemotherapy is advocated as the main treatment in recent years, and radiotherapy is used with caution to avoid delayed damage to reproductive organs and bone development during radiotherapy.