An 18-year-old girl undergoes right oophorectomy for a 12 cm ovarian mass. Histology shows immature teratoma Grade 3. What is the recommended adjuvant management?

• A No adjuvant therapy for Stage IA immature teratoma any grade
• B Whole-abdominal radiation therapy
• C Surveillance only with serum AFP monitoring
• D BEP (bleomycin-etoposide-cisplatin) chemotherapy for 3–4 cycles ✓

Explanation

Immature teratoma is graded 1–3 by the proportion of immature (primitive neuroepithelial) tissue. Grade 3 (any stage) and Stage IC or above (any grade) require adjuvant BEP chemotherapy (3–4 cycles). Stage IA Grade 1 immature teratoma is the only subgroup managed with surveillance alone. Grade 3 signifies high malignant potential regardless of stage, and BEP achieves cure rates >90%. Serum AFP is not the primary marker for pure immature teratoma (it is elevated in mixed germ cell tumors with yolk sac elements).

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.