Facts About Cystic Teratoma
- Tumors originating in the fetus and therefore several different cell types. Occurs most often as tumor or cyst in the ovaries in young women, but can also be seen in the testes in boys before puberty
- Are usually found during routine examination of the fetus by ultrasound, or by gynecological examination of adult women
- Treatment is removal of the tumor by surgery
What is a cystic teratoma?
Teratomas are tumors that are formed of multiple cell types. The tumor originated from germ cells (germinal cells) in the embryo stage. Includes both benign teratomas, well-developed cysts (cavity) opening and compact, immature malignant tumors. The benign cysts predominate, but there is always a small risk that a benign tumor becomes malignant.
Cystic teratomas are also called dermoid cysts. Some use the term tvillingecyster, but there is not a twin.
As a teratoma formed from germ cells, these cells can develop into different types of tissue. Thus, one can inside a teratoma find both hair, teeth, fat, skin, muscle, bone and hormonal tissue.
How common are cystic teratoma?
Cystic teratoma is a rare condition, but is found in some of the younger women who have a tumor / cyst in the ovaries. Overall, it seems three of four teratomas in girls. The location of teratomet depends on age. In infants and early childhood is the most common location outside the genitals. Later in childhood and adulthood are teratomas often in the ovaries and testes.
The four most common locations for teratomas are coccyx (sacrococcygeale teratomas) of the ovaries (ovarian teratomas), in the testis (testicular teratomas) and in the thoracic cavity (mediastinal teratomas). In rare cases may occur on the neck and inside the brain.
Sacrococcygeale teratomas account for 60% of all teratomas and are the most common tumors in newborns. They occur in 1 of 20,000-40,000 newborns. The condition may also occur during the fetal stage. It is much more common among girls (3-4: 1).
Ovarian teratomas (dermoid cysts in the ovary) is about 30% of all teratomas and 10-20% of all ovarian tumors. It is the most common tumor in the ovaries of girls under 20 years. The tumors can be found on both sides of 10-15%. They occur most frequently in reproductive-age and usually occurs early in the 30s.
Testicular teratomas are rare, but represent a much larger share of all testicular tumors in boys before puberty.
Mediastinal teratomas are relatively rare. They can occur in all age groups but is most common in the 20-40 age.
What causes cystic teratoma?
Teratomas due to an error the development of germ cells during fetal life.
What are the symptoms of cystic teratoma?
These tumors often detected by ultrasound examination during pregnancy, but can also be discovered after birth. There is a poorer chance of being healthy if already discovered a sacrococcygealt teratoma during pregnancy than if it first appears after birth.
In fetuses, scientists forecast that half door, while 85% of those born alive survive. If signs of developing complications in the fetus, it may be necessary to release the child too early. In this situation, one must consider the pros and cons and take into account how mature the baby’s lungs are. Among live-born, the challenges are also other possible congenital defects, damage due to pressure from the tumor, if it is large, and the problems associated with the operation.
Dermoid cysts on the ovaries are usually relatively peaceful, but can cause various complications. The cyst may cause the oviduct / ovary / cyst and wrap around (torsion). It can lead to reduced or abolished blood flow to the ovary and provides acute abdominal pain. It can take hole of cyst that may occur infection, and hemoglobin level may fall. Rarely (in 0.1-2%) is converted to the tumor is a cancerous tumor. Torsion is the most frequent complication and occurs in approximately 10% of cases.
Pure teratomas represent a very high proportion of all tumors of the testicles in children, but yet it is a rare condition. These tumors are almost all benign. After puberty is teratomas in the testicles rarer where they constitute only 2-3% of all testicular tumors, and they are usually malignant.
Teratomas in the chest behind the breastbone and the throat is almost always benign. The cured by surgery. The intervention, however, can be challenging due to cystens location close to vital organs like the heart and lungs.
How is it diagnosed?
They discovered either by ultrasound examination during pregnancy or as visible tumors at the bottom of the back of the newborn child. More unusually, the condition can manifest as an imbalance in the buttocks in the newborn. In other cases, the tumor becomes visible only later, usually between the ages of 1 month to 4 years.
Ovarian teratomas (dermoid cysts)
Benign cystic teratoma of the ovary detected usually randomly by gynecological examination in connection with x-ray examinations or in connection with abdominal surgery for other reasons. Asymptomatic ovarian teratomas is not so rare.
Teratomas abdominal pain, filling in the stomach or abnormal menstrual periods. Bladder Symptoms gastrointestinal discomfort and back pain are rarer. Torsion and acute rupture is usually associated with severe pain.
The mostly appears as a node in the scrotum, unless there is a twisting of testicular stem (torsion). The tumor is firm or hard in 80% of cases. Most are uømme.
These are usually without symptoms. Tumors that press on the surrounding tissue, can cause chest pain, coughing, shortness of breath or frequent pneumonias. Mediastinal teratoma detected sometimes randomly associated with X-ray of the lungs.
The report includes mainly the X-ray, ultrasound, sometimes CT scan and MRI scan.
In some cases, taking a tissue sample (biopsy) of the tumor to make the diagnosis.
What treatment is there?
The treatment of teratomas are mainly operation.
If diagnosed during pregnancy, the fetus / child followed closely by repeated ultrasound scans. In fetuses with a tumor larger than 5 cm, doctors will consider performing caesarean . In fetuses under 30 weeks of age, it may in some cases be considered to operate the baby while it is inside the uterus. In most cases removed teratomet in the first week of life, because later interventions are associated with higher risk that the tumor is malignant. Coccyx is removed along with the tumor.
Benign ovarian teratomas operated by the APCM to remove the cyst and preserve most of the ovary. It examined simultaneously, on the other ovary also contains teratoma. In older women can choose to remove teratomet with ovary and fallopian tube, especially if there are adhesions. Most operations are carried out today by keyhole surgery. Although the development of cancer is rare, it is recommended to remove the entire cyst by surgery, and not only remove parts of it or just empty it. The risk of recurrence of the cyst is 4% and conversion to cancer 0.2-2%.
These have traditionally been treated by the removal of the testicle. In recent times, we recommend peeling teratomet out and preserve the testis in boys before puberty. The risk of developing testicular cancer increases with maturation of the testicles. Boys in or near puberty is therefore usually removed surrounding normal testicular tissue during surgery. The tissue is examined microscopically, even while the boy is an anesthetic. If signs of cancer development is removed throughout the testis. In adult men removed the testicle always.
Mature teratomas in the mediastinum should be completely removed by surgery. The tumor can be grown fast to surrounding structures. This may make it necessary to remove part of the pericardium, pleura, or lung. When complete removal is long-term prognosis excellent.
How is long-term prospects?
In early and proper treatment, the prognosis is excellent. Possible complications depends on the tumor’s location. The risk of cancer development is generally very small, but requires early surgical intervention. In some cases, the surgery itself be risky.