MATURE CYSTIC TERATOMA - A CLINICOPATHOLOGICAL EVALUATION OF 517 CASES AND REVIEW OF THE LITERATURE

Objective: To evaluate the clinical and pathologic presentation of mat ure cystic teratomas and the trends in management over a 14-year study period. Methods: Tumor registry data and medical records between Janu ary 1, 1975 and December 31, 1989 were analyzed with respect to patien t age, tumor size, bilaterality, malignant transformation, and treatme nt. Results: Five hundred seventy-three tumors were removed from 517 p atients. The median and mean (+/- standard deviation) age was found to be 30 and 32 +/- 11.3 years, respectively. Three hundred ten (60%) of the patients were asymptomatic. The mean tumor size was 6.4 +/- 3.5 c m. The bilaterality rate was 10.8%. The rate of torsion was 3.5%; larg er tumors underwent torsion more frequently than smaller tumors (P = . 029). The rate of malignant transformation was 0.17%. The mean cyst di ameter for patients undergoing cystectomy was 5.7 +/- 2.4 cm; for ooph orectomy, 8.0 +/- 4.1 cm; and for hysterectomy, 6.1 +/- 3.8 cm. Oophor ectomies were performed for larger tumors when compared to cystectomie s (P = .01). The number of hysterectomies was stable throughout the st udy period, whereas the number of oophorectomies decreased and the num ber of cystectomies increased markedly. Contralateral ovarian biopsy w as common (48.5%) early in the study period. By 1989, the biopsy rate was less than 1%. Conclusions: We found the prevalence rates of sympto matic tumors, torsion, and malignant degeneration to be less than thos e previously reported by most other investigators. In addition, there has been an important change over the past 14 years in the management of these neoplasms, with an increased tendency for ovarian preservatio n, as evidenced by the more frequent use of cystectomy and a decrease in contralateral ovarian biopsy.