Diagnosis and treatment of intracranial immature teratoma.
OBJECTIVE
The purpose of this paper is toexplore the clinical features, treatment and prognosis of intracranial immature teratomas.


METHODS
The clinical data, serum levels of tumor markers, treatment regimens and prognosis of 15 patients with intracranial immature teratomas were reviewed retrospectively.


RESULTS
In patients whose plasma alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-HCG) were determined, AFP and beta-HCG were elevated in 57.1 and 16.7% of the cases, respectively. All patients received surgical treatment. The tumor was totally removed in 12 cases, subtotally in 2, and partially in 1 case. After surgery, of the 15 patients, 9 received radiotherapy, 4 gamma knife surgery and 7 chemotherapy. Thirteen patients were followed up. Compared to the common 5-year survival rate of 40%, in patients who received gamma knife surgery, the 5-year survival rate after surgery was 100%, which is better than the 5-year survival rate of patients who did not receive gamma knife surgery (p = 0.0049). Postoperative radiotherapy and chemical therapy had no significant impact on the 5-year survival rate (p > 0.05).


CONCLUSIONS
The prognosis of intracranial immature teratomas is poor. The detection of their clinical manifestation, the analysis of imaging features and the serum levels of tumor markers are helpful in diagnosing intracranial teratomas. The total removal of the tumor is important to cure the disease. We did not see a difference in outcome between patients who received postoperative chemotherapy or radiotherapy and those who did not. Regular follow-up MRI examinations are necessary so that the conditions of the patients can be closely monitored. If a patient has residual or recurrent tumor after surgery, gamma knife surgery can be effective.
Huang
Xiang
X
Department of Neurosurgery, Huashan Hospital, and Department of Neurosurgery, Shanghai Medical College, Fudan University, Shanghai 200040, PR China.
Zhang
Rong
R
Zhou
Liang-Fu
LF
D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy; D002648:Child; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D016634:Radiosurgery; D012189:Retrospective Studies; D015996:Survival Rate; D013724:Teratoma / Q000473:pathology / Q000601:surgery / Q000628:therapy; D020542:Third Ventricle / Q000473:pathology; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism
D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins