title: Treatment and outcomes of primary intracranial teratoma.
abstract: OBJECTIVE
  Until recently, postoperative adjuvant treatment for intracranial teratomas has remained controversial because of the rarity of the tumors and the heterogeneity of histologic types. To define optimal therapy modalities, we retrospectively analyzed the treatment of patients with intracranial teratomas.
  
  
  METHODS
  Between 1979 and 2007, 31 patients with intracranial teratomas were treated at our institution. The median age of the 31 patients was 14.8 years. The median follow-up time was 72.7 months (range 11 approximately 291 months). Perioperative radiochemotherapy was done in 19 patients. Proper chemotherapy regimens were followed, such as PE (cisplatin and VP-16), PVB (cisplatin, VP-16, and bleomycin), ICE (carboplatin, VP-16, and ifosfamide), and NGGCT (etoposide, carboplatin, bleomycin, and cyclophosphamide with mesna).
  
  
  RESULTS
  Eight patients experienced recurrence, and a second operation was carried out in six patients. Fifteen patients survived for more than 5 years without recurrence, irrespective of having received adjuvant therapies. The 5-year survival rate of the 31 patients was 74%.
  
  
  CONCLUSIONS
  Treatment of intracranial teratomas is very difficult because of the heterogeneity of the tumor cells from totipotent origins. Accurate histological diagnosis of teratoma subtypes is the most important factor for adequate treatment, and proper therapeutic protocols are needed to cure teratomas.
authors.affiliation: Department of Neurosurgery, Severance Children's Hospital, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Yun-Ho
authors.initials: YH
authors.lastname: Lee
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Park
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Park
authors.forename: Kyu-Won
authors.initials: KW
authors.lastname: Shim
authors.forename: Joong-Uhn
authors.initials: JU
authors.lastname: Choi
authors.forename: Dong-Seok
authors.initials: DS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D013724:Teratoma / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome
references.citation: Pediatr Neurosurg. 1996 Nov;25(5):240-6; discussion 247
references.pmid: 9309787
references.citation: Neurosurgery. 1994 Mar;34(3):524-9; discussion 529
references.pmid: 7514765
references.citation: Neurosurgery. 2005;56(1):188
references.pmid: 15617603
references.citation: Neuropediatrics. 1994 Feb;25(1):26-32
references.pmid: 8208347
references.citation: Med Pediatr Oncol. 1994;22(2):137-9
references.pmid: 7505047
references.citation: Childs Nerv Syst. 1997 Oct;13(10):556-9
references.pmid: 9403206
references.citation: Med Pediatr Oncol. 1995 Jan;24(1):53-7
references.pmid: 7968794
references.citation: J Neurosurg. 1997 Mar;86(3):446-55
references.pmid: 9046301
references.citation: Childs Nerv Syst. 2007 Jun;23(6):713-8
references.pmid: 17187270
references.citation: J Neurosurg. 1998 Nov;89(5):728-37
references.pmid: 9817409
references.citation: Cancer. 2003 Jul 15;98(2):369-76
references.pmid: 12872359
references.citation: J Neurosurg. 1991 Apr;74(4):545-51
references.pmid: 1848284
references.citation: Klin Padiatr. 1997 Jul-Aug;209(4):222-7
references.pmid: 9293454
references.citation: Acta Neurochir (Wien). 1995;134(3-4):130-5
references.pmid: 8748771
references.citation: J Neurosurg. 1985 Aug;63(2):155-67
references.pmid: 2991485
references.citation: Curr Opin Neurol. 1996 Dec;9(6):419-23
references.pmid: 9007398