Teratoma is a rare cancer that affects the reproductive organs. When 18-year-old Yasmin* was diagnosed with this condition, her life was turned upside down. However, with the collaborative efforts of physicians from two Haifa hospitals and a specialized surgical intervention, Yasmin, now 21, is hopeful for a healthy and promising future.
Three years ago, while preparing for her college entrance exams, Yasmin began feeling weak, dizzy, and experienced sharp abdominal pain. "I called my mother, who thought the pain might be due to sitting for long periods," she explains. However, when Yasmin noticed her stomach was unusually swollen, she knew something was wrong. "Who would have thought it was cancer?" she reflects.
Her parents took her to the emergency room at Carmel Medical Center (Carmel), where Dr. Yakir Segev, Director of the Gynecologic Oncology Unit, discovered a large tumor on her ovary. In a complex surgery, most of the tumor was removed. A biopsy revealed it was a teratoma—a rare cancer affecting the reproductive organs. “Apparently, the tumor had been growing for years without symptoms—until it finally ruptured and metastasized,” Yasmin recalls. Chemotherapy followed, and while everyone hoped it would be effective, Yasmin’s condition required close monitoring. Following her first surgery, she enrolled in college. However, doctors noticed that the cancer had spread.
Dr. Segev contacted Dr. Shifra Ash, Director of the Joan & Sanford Weill Division of Pediatric Hematology-Oncology and Bone Marrow Transplantation at Rambam Health Care Campus (Rambam) in Haifa, Israel and an expert in pediatric cancers. “Rambam and Carmel have collaborated on rare cancer cases in children and teenagers in recent years. “It’s important for us to mobilize all possible resources to treat patients effectively, especially when it’s a matter of saving lives,” Ash emphasized.
Ash explains, “It’s crucial to differentiate between ovarian cancer in children and adults in terms of prevalence, genetics, and recovery. Teratoma is rare; in Israel, only a few cases are diagnosed annually.”
To determine the best course of action, Ash and Segev also consulted with Dr. Aviad Hoffman, who directs both Rambam’s Breast Health Institute and Breast Surgery Unit and in charge of the hospital’s peritoneal malignancies program.
L) Dr. Aviad Hoffman and R) Dr. Shifra Ash. Photography: Rambam HCC
Ash adds, “teratoma tumors are a particular group of germ cell tumors affecting the reproductive organs, accounting for about three percent of all pediatric cancer cases. The cause is unknown, but symptoms include abdominal swelling, pain, and sometimes menstrual disorders. While mature teratomas are usually benign, immature teratomas can have malignant elements. Treatment typically involves a combination of surgery and chemotherapy, but some cases, like Yasmin’s, resist therapy and recur.”
“We consulted with colleagues in the United States and decided to proceed with another surgery,” says Ash. “We chose HIPEC [hyperthermic intraperitoneal chemotherapy] surgery—a type of chemotherapy used in combination with abdominal surgery to treat advanced abdominal cancers and often used to treat young girls.” In this 8-10 hour procedure, warmed chemotherapy medications are infused and circulated in the abdominal cavity for a short time. HIPEC carries a significant risk of complications. Yasmin’s parents were consulted, and in February, Hoffman—one of Israel’s most experienced HIPEC surgeons—performed the surgery with Segev.
Now 21, Yasmin is determined to overcome her condition. “Six months after the surgery, I felt much better,” she recalls. “It was complex, both physically and emotionally, but every day I get stronger. In November, I’ll be able to return to college.” It will take the physicians two years to make a final assessment of her condition but, in the meantime, she is making up for lost time by learning to drive and taking swimming lessons.
“I am strong, and in a few years, I hope to be able to support other girls going through this,” Yasmin says. “I’m dealing with a lot, but I’m embracing the journey.”
*Name changed to protect her identity
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