Five-year remissions of metastatic solid teratoma of the ovary.

To date, only three 5-year survivors with metastatic solid malignant teratoma of the ovary have been reported. The authors report two additional cases surviving 5 years or greater. In both cases, the embryonal teratomatous elements matured to Grade 0 peritoneal metastases after intensive chemotherapy and surgery with or without radiotherapy. Since only one of the two patients had an objective response to therapy, we speculated that the maturation of the tumor in both patients might be, but is not proven to be, a consequence of chemotherapy, surgery, and/or radiotherapy. Because the prognosis, even in Stage IA solid ovarian teratoma, is so poor, we suggest that all such patients should have 2 years of adjuvant chemotherapy consisting of vincristine, dactinomycin, and cyclophosphamide. Patients with demonstrable metastases should receive the same chemotherapy until either all tumor has regressed or all immature elements have reverted to mature tissue.