PRIMARY MALIGNANT TERATOMA OF THE THYROID-GLAND - REPORT AND DISCUSSION OF 2 CASES

Background. Teratoma of the thyroid in adults is a rare neoplasm and i s usually seen in young females. Most of the thyroid teratoma are mali gnant. The tumor appears as a dominant mass in the thyroid gland and i s often associated with local lymph node involvement. We describe our experience of primary malignant teratoma of the thyroid in two young w omen who were treated with aggressive chemotherapy and surgical interv ention. Methods. Medical records of two patients treated between 1993 and 1995 were reviewed. Both patients were women (36 years old and 34 years old). The diagnosis of primary malignant teratoma of the thyroid was made on the basis of clinical, radiographic, and microscopic find ings. Patients were treated with aggressive combination chemotherapy c onsisting of alternating regimens similar to those used for high-volum e germ-cell tumor patients at the University of Texas M. D. Anderson C ancer Center. Results. One of the patients demonstrated a partial resp onse to chemotherapy and underwent postchemotherapy surgery for remova l of residual disease. The other patient had a complete response to ch emotherapy. Both patients are alive and disease free for 32- and 26-pl us months. Conclusions. Primary malignant teratoma of the thyroid is s ensitive to combination chemotherapy. It appears that the treatment st rategy offered-aggressive induction chemotherapy with planned surgery for removal of residual disease, similar to that for patients with tes ticular tumors-has the potential to provide a durable, complete remiss ion. (C) 1998 John Wiley & Sons, Inc.