PRIMARY IMMATURE MEDIASTINAL TERATOMA IN ADULTHOOD

Primary immature mediastinal teratoma is very rare. The prognosis of t his tumour observed in the late teens or adulthood was thought to be v ery poor. However, recent advances in chemotherapy have improved the p rognosis. Eleven patients >15 years of age with immature mediastinal t eratoma (two of our patients and nine from the literature) were review ed. These patients mere classified into survivor and non-survivor grou ps, and the characteristics in each group were evaluated. In the survi vor group, the tumour was completely resected in ail patients. In addi tion, patients showing a high level of alpha-fetoprotein mere treated by pre-operative chemotherapy, and those who mere pre-operatively nega tive for tumour markers were treated by post-operative chemotherapy an d survived for a long period. All patients in whom the tumour was rese cted incompletely, or where no chemotherapy was performed, were includ ed in the non-survivor group. In patients >15 years of age with immatu re mediastinal teratoma, complete surgical resection of the tumour is indispensable. When complete resection is combined with chemotherapy, long survival can be expected. Conversely, unless both treatment metho ds are performed, the outcome is very poor.