Teratomas in Children: Epidemiologic Features

Abstract

In a search for etiologic clues, study was made of 369 death certificates for U.S. children who died from teratomas in 1960–68, and of 198 hospital charts of children with this tumor. Mortality rates for girls exceeded those for boys, as contrasted with the usual male preponderance for childhood neoplasia. There was a peak in deaths under age 3, primarily from sacrococcygeal tumors in girls. Arising trend in mortality developed after age 6 for ovarian tumors and after age 14 for testicular tumors. Although the cellular basis for teratomas remains unsettled, the female predominance at various sites is consistent with the concept of a common origin: Pluripotential germ cells which account for gonadal teratomas in older children may, if ectopic early in fetal life, give rise in infancy to sacrococ-cygeal and possibly other extragonadal teratomas. Furthermore, a high .frequency of children with sacrococcygeal teratomas had congenital anomalies involving the lower vertebrae, genitourinary system, and anorectum. The array of defects included duplication of pelvic organs attributable to hindgut twinning. Perhaps certain anomalies near teratomas are not due to the effects of local tumor growth, but result from the same developmental aberration responsible for the formation of teratomas.