Immature teratoma of the ovary. Correlation between serum alpha-fetoprotein value and immunohistochemical analysis.

Immature Teratoma of the Ovary Abstract Seven immature ovarian teratomas associated with elevated serum alpha-fetoprotein (AFP) are presented. The primary tumors and their metastatic lesions were histologically graded from zero to three, and stained by alpha-fetoprotein peroxidase anti-peroxidase (AFP-PAP) method. The grades of metastatic lesions were correlated with their prognosis. AFP-PAP staining revealed that the glandular epithelia were only positive for AFP, strongly suggesting the site of producing AFP. Serum alpha-fetoprotein remained within the normal range in spite of the increments of metastatic lesions in case 3. This may be explained by the fact that alpha-fetoprotein production by glandular epithelium was not observed in the specimens obtained at second-look surgery in this particular case. Therefore, serum AFP may not always be an indicator of extension of this tumor, but is related to the amount of AFP produced by the glandular epithelia. Therefore, in immature teratomas the stress is on the serial measurements of serum alpha-fetoprotein, the identification of the alpha-fetoprotein-producing lesion in immunological staining and the confinement of the malignant germ cell elements.