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Teratoma – Images, Symptoms, Causes, Treatment

Updated on February 19, 2014

A tumor that contains different types of tissues and is already present before birth is called a teratoma. The term "teratoma" is Greek in origin and means "monstrous tumor." It is named such because the tumor is composed of organs or tissues of various parts of the body. In general, the tissues that make up a teratoma differ from the surrounding tissues in which it is found. Some instances of teratomas involve organs and tissues of the hand, teeth, bone and even eyeballs. But in majority of cases, teratomas are made up of brain, liver, lung and thyroid tissues. Three germ layers or embryonic layers, namely the ectoderm, mesoderm and endoderm could be found in teratomas. But usually, only two of these can be identified.

What are the types of teratomas?

A teratoma could be benign or malignant. It could grow rapidly or spread aggressively. Teratomas found in infants are usually harmless and do not spread. However, there are instances in which the tumor becomes malignant, depending on the tissues contained therein. Some teratomas grow rapidly but are benign and do not spread to other parts of the body; whereas others both grow and spread aggressively making them malignant.

Teratomas can be grouped according to what is found inside them.

  • Solid teratoma - The tumor consists of tissues and some complex structures.

  • Cystic teratoma - The tumor is fluid-filled. It may contain pure fluid or semi-fluid, like fat, sebum and cerebrospinal fluid.

  • Mixed teratoma - These teratomas consist of both fluid and solid portions.

These tumors are likewise classified according to their level of malignancy. The Gonzalez-Crussi system is employed to indicate whether a tumor is benign or malignant. The system is as follows;

  • 0 - Benign or mature
    These teratomas are typically the cystic type. Grade 0 teratomas are harmless but carry some risk of turning malignant. This has been found to be the case in some endodermal sinus tumors and squamous cell carcinomas.

  • 1 - Probably benign or immature
    This type has a higher chance of turning malignant than grade 0, therefore, proper follow up is recommended. Grade 1 is not as easy to diagnose as the others since it can simply be thought to be similar to other small cell neoplasms.

  • 2 - Possibly malignant, immature

Teratomas classified as grade 2 has a good chance of proving to be malignant. It can spread to other parts of the body.

  • 3 - Frankly malignant

These teratomas are absolutely cancerous.

What causes teratoma?

The reason behind the development of a teratoma remains unclear. In the old days, some of the conjectures about the origin of teratomas include eating hair or teeth, or a result of a witch’s curse or nightmares. Currently, there are theories that associate teratoma formation with a number of genetic abnormalities that involve the lower spine, nervous system, and genitourinary system. Teratomas form from primordial germ cells is referred to as parthenogenic theory. On the other hand, many of the malignant cases have been associated with the presence of other tumors, such as:

  • AML (Acute myelogenous leukemia)

  • Malignant histiocytosis

  • Myelodysplasia (MDS)

  • Small cell undifferentiated carcinoma

  • MDS (Myelodysplasia)

  • Embryonal rhabdomyosarcoma

What are the signs and symptoms that accompany teratomas?

A teratoma can be tied in with a wide assortment of symptoms which are dependent on where the tumor is situated and whether it is benign or malignant. Some of the signs and symptoms that are present with teratomas are the following:

  • Constipation

  • High levels of B-HCG (beta-human chorionic gonadotropin)

  • Incontinence

  • Increased quantity of alpha-fetoprotein (AFP)

  • Pain

  • Swelling

  • Tenderness

  • Tumor or mass that can be felt or seen

  • Weakness in the legs

Some of the hallmark symptoms of malignant teratomas, especially those that are located in the chest area, include:

  • Coughing

  • Difficulty in exercising or intense physical activity

  • Overall feeling of fatigue

  • Pressure or pain in the chest

  • Shortness of breath

How are teratomas diagnosed?

Since teratomas are believed to be congenital, the presence of a teratoma within the fetus can be diagnosed through prenatal ultrasound. This is especially the case for large tumors such as cervical teratomas and sacrococcygeal teratomas. Though very rare, there are instances in which the tumor is so big that it overwhelms the fetus resulting in fetal death.

Even if these tumors already exist prior to birth, many cases of teratomas are discovered much later in life, either during childhood or adulthood. Some of the procedures employed for diagnosing teratoma are:

  • Biopsy

  • Complete blood count and other blood tests

  • CAT Scan

  • MRI

  • X-ray

  • Somography

How are teratomas treated?

The primary treatment for teratoma is the complete removal of the tumor by surgery. After which, chemotherapy may be done if the tumor is malignant. Individuals with teratomas have to have frequent follow-ups to monitor the progress of the treatment and the status of the tumor.

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