Malignant childhood teratomas in the Nigerian savannah

At the Ahmadu Bello University Hospital in Zaria within the Guinea Savannah of Nigeria, 54 childhood teratomas were seen between 1972 and 1983. Four of the 28 sacrococcygeal, three of the 13 ovarian and the only lumbar teratoma were malignant. Surgical excision was the mainstay of management and adjuvant therapy with vincristine, actinomycin D and cyclophosphamide (VAC) was planned but was not always executed because of irregular drug supply. Two of the children died in the hospital and three were discharged home for terminal care; two with malignant ovarian teratomas survived at least for 15 and 18 months respectively, but with evidence of distant spread. It is concluded that surgery alone is unlikely to cure these malignant tumours but that improvement in the prognosis of these lesions in Nigeria must await the availability of combined therapy with multiple cytotoxic drugs and irradiation.