Treatment of children with dysgerminoma of the ovary.

The therapeutic approach to dysgerminoma, the most common malignant ovarian tumor in children, has been primarily surgical, with radical excision for tumors extending beyond their capsule. Four children with localized disease were treated with limited surgery only and are free of disease. Five others with extensive disease were treated with chemotherapy as the primary therapeutic modality, with or without adjuvant radiotherapy, and three are alive and remain free of disease. Only the two patients with an admixture of other malignant germ cell tumors had recurrence of the other malignant elements after an initial good response. This experience demonstrates pronounced in vivo tumoricidal activity and supports a therapeutic approach to existence childhood dysgerminoma with an initial chemotherapeutic regimen, resulting in sparing of pelvic and reproductive organs.