Malignant teratomas in infancy and childhood

In infancy and childhood, 75% of teratomas occur in females. The most common site is the sacrococcygeal area. The second most common site is the ovary, followed by lesser numbers in many anatomic areas, exclusive of the extremities. The majority of malignant teratomas are in the sacrococcygeal group. Approximately 1/2 of sacrococcygeal teratomas are composed of benign adult tissue. Twenty percent contain embryonic benign tissue and approximately 30% have overtly malignant tissue. With the exception of central nervous system teratomas, the percentage of malignancy is less in other sites. The malignant teratoma is aggressive in its clinical course. At the present time, approximately 80% of patients with malignant teratomas die as a result of the malignancy. Subsequent to appropriate surgical therapy, aggressive radiation and chemotherapy are indicated for treatment of malignant teratomas.