INCIDENCE OF PRIMARY MALIGNANT TERATOMAS

Frequency of malignant teratoma is, is, according to the literature, 2 %-10%. Examining 194 own cases (1983-1993) it was 1.5%. We found one s quamous cell carcinoma (0.5%). Additionally we found 2 immature terato mas (1%). We point out the different biological behaviour of malignant mature teratomas and immature teratomas, We agree with the majority o f authors that the method of choice is the intact removal of all terat omas without iatrogen rupture or contamination of the abdominal cavity by contents of the teratoma, This adequate surgical procedure can and should be performed by laparotomy or laparoscopy with endobag. The of ten practised method of cutting open the cyst during laparoscopy, suck ing off the contents or cutting the teratoma into pieces; has been pro ven to lead to implantation and worsening the prognosis in case of a m alignant teratoma, Even the rinsing of the abdominal cavity, usually c arried out with this method, could not compensate always for the disad vantage of this ''dirty'' endoscopical method compared with usual onco logical standards. This is pointed out by case reports in the literatu re and the first analysis of a German survey with early-follow-up of 1 92 laparoscopically managed ovarian malignancies [11a]. The principle of intact removal of every teratoma should again be kept in mind.