Teratomas with malignant transformation refer to lesions which give rise to malignant cancer of somatic type. Teratoma definition of teratoma by medical dictionary. It is a benign or malignant tumor belonging to a group of germ cell tumors. Benign enhancing components of mature ovarian teratoma. The association between tumors of dermoid origin and klippelfeil. Mature teratoma mt, which is composed of welldifferentiated tissues that derive from all three germcell layers ectoderm, mesoderm and endoderm, is one of the most common benign ovarian neoplasms, accounting for 20% of adult ovarian tumors and 50% of pediatric ovarian tumors. Ovarian teratomas represent 15% to 20% of ovarian germ cell tumors. Although they have very similar imaging appearances, the two have a fundamental histological. The immature form was first described in 1960 by thurlbeck and scully, and can be pure or mixed with a mature component 1. The most common pattern is in neonates, who present with a large, predominantly benign tumor protruding from the sacral area that is noted prenatally or at the time of delivery.
The benign cystic teratoma shows typical imaging manifestations and can be complicated by torsion, rupture and uncommonly malignant degeneration. What is teratoma and what causes it answers on healthtap. Because malignant teratomas have usually spread by the time of diagnosis, systemic chemotherapy is needed. Sacrococcygeal teratoma abbreviated as sct, is a kind of teratoma tumor that is commonly developed at the base portion of the coccyx and is believed to have a primitive streak as basis for its structural formation. Computed tomography images showed a left adnexal mass with fat, calcification and soft. Us and mr imaging features of the various types of mature and immature ots. Nevertheless, the presence of afetoprotein raises the possibility of a mixed germcell tumor. Inconsistent nomenclature often confuses discussions of various subtypes of teratomas. Ovarian teratomas ots are the most common germ cell neoplasm. A teratoma is a rare type of tumor that can contain fully developed tissues and organs, including hair, teeth, muscle, and bone. The patient received no further therapy and was well during followup. As you seem to recognize, the right first steps are imaging and biopsy. The primordial germ cell is the principal but probably not the exclusive progenitor of a teratoma.
In tumor marker negative group clinical examination and imaging techniques are required for. When a mass is in the area described mediastinum the most common possibilities include lymphoma, thymoma, thymic carcinoma, lung cancer and teratoma. Intracranial teratomas are nongerminomatous germ cell tumors and they account for 0. The floating ball sign was demonstrated in crosssectional imaging in 30 25. Jingwei zhao 1, haifeng wang 1, jing yu 2, yanping zhong 3, pengfei ge 1. Teratoma by its various types is one of the common lesions facing the radiologists in their daily work. Ovarian teratomas include mature cystic teratomas dermoid cysts, immature teratomas, and monodermal teratomas eg, struma ovarii, carcinoid tumors, neural tumors. The monodermal teratomas which include the struma ovarii may also have specific imaging characteristics that should be recognised on imaging. A testicular teratoma may present as a painless lump. Ct and mr imaging of pelvic regions are usually diagnostic of ovarian teratomas, wherein a ct shows typically fatattenuated within a cyst, and an mr usually reflects the identification of the sebaceous components.
However, the spectrum of appearances ranges from a predominantly cystic to a mostly solid mass. Theyre most common in the tailbone, ovaries, and testicles. Only approximately one third of immature teratomas have raised afp, and they are usually negative for other tumor markers 58. Ovarian dermoid cyst and mature cystic ovarian teratoma are terms often used interchangeably to refer to the most common ovarian neoplasm. To reach the diagnosis of a struma ovarii, the tumor. Ultrasonography features and afp results for the paents examined. Immature teratomas tend to be larger than mature cystic teratomas at initial presentation.
The typical imaging characteristics of mature cystic teratomas are well known, but some atypical imaging manifestations can be misleading, such as tumors with scanty or without a fat component, pure fat in the cyst without the other component, a collision tumor, torsion, infection or rupture of teratoma, and association with a malignant. Immature ovarian teratoma radiology reference article. Teratomas are a subset of these neoplasms, and their finding in brain structures is exceptionally rare, and occurrence within the skull base is quite novel. Conversely, we could not find any reported cases of immature teratoma in such a situation. In 11 patients, we analyzed the imaging findings by the ct and mr focused on the soft tissue components for the following characteristics. Nov 18, 2004 the malignant transformation of an ovarian mature cystic teratoma is rare. In those not diagnosed antenatally, sacrococcygeal teratomas present in 2 patterns. These slowgrowing tumors contain elements from multiple germ cell layers and are best assessed with ultrasound. Mature cystic ovarian teratoma radiology reference. Teratomas are present at birth and may contain hair, teeth, and other tissues. The imaging appearance is typical of a large, heterogeneous mass with a prominent solid component. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Growing teratoma syndrome following primary ovarian immature teratoma 4861 int j clin exp med 2016.
A teratoma is a tumor made up of several different types of tissue, such as hair, muscle, teeth, or bone. The recent trend is to include teratomas under the classification of germ cell tumors. Jul 26, 2018 a malignant teratoma is a type of cancer consisting of cysts that contain one or more of the three primary embryonic germ layers. The type of tumor was recorded taking into account clinical and imaging followup, imaging guided biopsies and surgical specimens analysis. As a result they can contain a large variety of tissue types including. It results in abnormal cells that have the ability to invade or spread to other parts of the body. Intracranial germ cell tumors are uncommon and account for only 0. Aug 22, 2006 to evaluate the factors including the imaging findings and clinical and laboratory data that were useful for diagnosing mature cystic teratomas with malignant transformation. Utility of the floating ball sign in diagnosis of ovarian cystic teratoma. Discuss the embryologic origin and clinical features of teratodermoid lesions in various locations. Identify the radiologic characteristics of teratomas. Case report growing teratoma syndrome following primary. Extension through the tumor capsule may be present.
Cystic teratoma differential diagnoses medscape reference. Familiarity with the imaging features of giant ovarian teratomas. Ovarian teratoma symptoms, signs, pictures, causes, mature. Ultrasonography of immature teratomas international journal of. This is a tumor that is encapsulated and has either organ or tissue composition with a complete number of germ layers. They typically form in the ovary, testicle, or tailbone and less commonly in other areas. We describe the case of a 31yearold caucasian woman with primary infertility, who developed an. If you pinch a df, the upper skin above the lesion will dimple unlike other skin lesions. Atypical presentation of mature cystic teratoma floating balls. To the best of our knowledge, no cases of immature. Ots are usually characterized by ultrasound us and magnetic resonance mr whereas they are usually an incidental finding on ct.
Current management of immature teratoma of the ovary. Differentiate between mature cystic teratomas, immature teratomas, and monodermal teratomas on the basis of histologic and radiologic findings. To reach the diagnosis of a struma ovarii, the tumor must either composed in more. Subtypes of teratoma include mature cystic, immature and the monodermal teratomas. The prognosis for people with malignant teratomas is based on the size of the tumor, its location and the age of the patient. Mature teratoma is the most common benign tumor of the ovary. Jan 29, 2009 london, england cnn teratomas of the brain are very rare and comprise less than 1 per cent of all brain tumors. Ovarian teratomas include mature cystic teratomas dermoid cysts, immature teratomas, and monodermal teratomas eg, struma ovarii. On occasion, mature teratomas contain elements that undergo malignant transformation most commonly. Background a tumor comprising of different types of tissues such as hair, muscle, bone, etc. To access imaging findings of growing teratoma syndrome gts, which is a rare complication of malignant ovarian germ cell tumor gct after chemotherapy. The patient had suffered from fullness and tenderness of the lower abdomen for one year. Malignant transformation of an ovarian mature cystic teratoma.
The pattern of shading was also described for each case. Tumor types and imaging characteristics1 learning objectives for test 6 after reading this article and taking the test, the reader will be able to. The discovery of a mature teratoma dermoid cyst of the ovary during ovarian stimulation is not a rare event. The objectives of this study were to describe mr imaging findings of immature teratoma and to correlate imaging findings with histopathologic findings. Enumerate the most common types of ovarian teratomas. Department of neurosurgery, first bethune hospital of jilin university, changchun 021, jilin province, p. It is encountered in about 1% of all ovarian teratomas. Diagnosis and management of an immature teratoma during. Imaging features of growing teratoma syndrome following a. Teratoma pictures, symptoms, treatment, causes, surgery information of teratoma. Additionally, teratomas may be monodermal and highly specialized.
Nov 22, 2019 teratomas are germ cell tumors commonly composed of multiple cell types derived from one or more of the 3 germ layers. Cerebral falx mature teratoma with rare imaging in an adult. Doctor answers on symptoms, diagnosis, treatment, and more. Discuss the histologic characteristics and specific us, ct, and mr imaging features of the various types of ovarian teratomas. Clinical and ultrasound arguments for this immature form are scarcely or poorly evaluated. Ovarian teratomas are the most common germ cell neoplasm. Teratomas range from benign, mature, welldifferentiated cystic lesions to immature, poorly differentiated lesions with solid components and malignant transformation. This mri scan shows a tumor teratoma at the base of the spine seen on the left lower edge of the screen, located in the sacrum and coccyx sacrococcygeal area. Most mature cystic teratomas can be diagnosed at ultrasonography us but may have a variety of appearances, characterized by echogenic sebaceous material and calcification.
Teratomas range from benign, welldifferentiated mature cystic lesions to those that are solid and malignant immature. Advancement in imaging techniques has aided in the diagnosis, as well as adequate planning prior to the surgery. We presented such a case of a 46yearold woman with characteristic computed tomography ct findings. Ovarian cancer is a cancer that forms in or on an ovary. Asymptomatic mature cystic teratomas of the ovaries have been reported at rates of 665% in various series. Pdf utility of the floating ball sign in diagnosis of ovarian cystic. Ct images of a malignanttransformed ovarian mature cystic. Tumor size, tumor characteristics and the number, size, and characteristics of floating globules were. Mature cystic teratomas of the ovary are often discovered as incidental findings on physical examination, during radiographic studies, or during abdominal surgery performed for other indications. I suspect that some result from bug bites but nobody knows. Teratomas arise from cells that can differentiate in to a host of tissue types and can be associated with chromosomal genetic abnormalities or with inherited syndromes.
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