Addressing the diagnostic and therapeutic dilemmas of ovarian immature teratoma: Report from a clinicopathologic consensus conference

Farzana Pashankar; Krisztina Hanley; Michelle Lockley; Sara Stoneham; Marisa R Nucci; Miguel Reyes-Múgica; Esther Elishaev; Russell Vang; Jennifer Veneris; Heather Rytting; Thomas Olson; Kim Hazard; Al Covens; Rupali Arora; Deborah Billmire; Alyaa Al-Ibraheemi; Thomas M Ulbright; Lindsay Frazier; Michelle S Hirsch

doi:10.1016/j.ejca.2022.06.006

Addressing the diagnostic and therapeutic dilemmas of ovarian immature teratoma: Report from a clinicopathologic consensus conference

Eur J Cancer. 2022 Sep:173:59-70. doi: 10.1016/j.ejca.2022.06.006. Epub 2022 Jul 18.

Authors

Farzana Pashankar¹, Krisztina Hanley², Michelle Lockley³, Sara Stoneham⁴, Marisa R Nucci⁵, Miguel Reyes-Múgica⁶, Esther Elishaev⁶, Russell Vang⁷, Jennifer Veneris⁸, Heather Rytting², Thomas Olson⁹, Kim Hazard¹⁰, Al Covens¹¹, Rupali Arora¹², Deborah Billmire¹³, Alyaa Al-Ibraheemi¹⁴, Thomas M Ulbright¹⁵, Lindsay Frazier¹⁶, Michelle S Hirsch¹⁷

Affiliations

¹ Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
² Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.
³ Department of Medical Oncology, University College Hospital, University College London Hospital, NHS Foundation Trust, London, UK; Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, UK.
⁴ Department of Pediatrics University College Hospital, University College London Hospital, NHS Foundation Trust, London, UK.
⁵ Department of Pathology, Women's and Perinatal Division, Brigham and Women's Hospital; Harvard Medical School, Boston, MA, USA.
⁶ Department of Pathology, University of Pittsburg Medical Center, Pittsburg, PA, USA.
⁷ Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, USA.
⁸ GlaxoSmithKline, Waltham, MA, USA.
⁹ Department of Pediatrics, Aflac Cancer and Blood Disorders Center, Emory University School of Medicine, Atlanta, GA, USA.
¹⁰ Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA.
¹¹ Division of Gyneacologic Oncology, University of Toronto, Sunnybrook Health Science Centre, Toronto, ON.
¹² Department of Gyneacology, University College Hospital, University College London Hospital, NHS Foundation Trust, London, UK.
¹³ Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
¹⁴ Harvard Medical School, Boston, MA, USA; Department of Pathology, Boston Children's Hospital, Boston, MA, USA.
¹⁵ Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
¹⁶ Harvard Medical School, Boston, MA, USA; Dana Farber/Boston Children's Cancer and Blood Center, Boston, MA, USA.
¹⁷ Department of Pathology, Women's and Perinatal Division, Brigham and Women's Hospital; Harvard Medical School, Boston, MA, USA. Electronic address: mhirsch1@bwh.harvard.edu.

PMID: 35863107
DOI: 10.1016/j.ejca.2022.06.006

Abstract

Ovarian immature teratoma is a rare subtype of germ cell tumour that can be pure or associated with non-teratomatous germ cell tumour elements and is graded based on extent of the immature neuroectodermal component. Immature teratoma (IT) can also be associated with somatic differentiation in the form of sarcoma, carcinoma, or extensive immature neuroectodermal elements and may produce low levels of serum alpha-fetoprotein. Variable interpretation of these issues underlies diagnostic and management dilemmas, resulting in substantial practice differences between paediatric and adult women with IT. The Malignant Germ Cell International Consortium (MaGIC) convened oncologists, surgeons, and pathologists to address the following crucial clinicopathologic issues related to IT: (1) grading of IT, (2) definition and significance of 'microscopic' yolk sac tumour, (3) transformation to a somatic malignancy, and (4) interpretation of serum tumour biomarkers. This review highlights the discussion, conclusions, and suggested next steps from this clinicopathologic conference.

Keywords: Immature; Neuroectoderm; Ovarian; Primitive neuroectodermal tumour; Teratoma; Yolk sac tumour.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Child
Consensus Development Conferences as Topic
Endodermal Sinus Tumor* / drug therapy
Endodermal Sinus Tumor* / therapy
Female
Humans
Neoplasms, Germ Cell and Embryonal* / diagnosis
Neoplasms, Germ Cell and Embryonal* / therapy
Ovarian Neoplasms* / drug therapy
Ovarian Neoplasms* / therapy
Teratoma* / drug therapy
Teratoma* / therapy

Supplementary concepts

Teratoma, Ovarian