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TERATOMAS
A teratoma is a rare type of germ cell tumor that may contain immature or fully formed tissue, including teeth, hair, bone and muscle. Most teratomas are benign (noncancerous) but they can be malignant (cancerous). Treatment involves surgical removal.
These are divided into three categories: mature (benign), immature (malignant), monodermal or highly specialized.
Mature (Benign) Teratomas :
- Cystic teratomas are usually found in young women during the active reproductive years.
- Characteristically, they are unilocular cysts containing hair and cheesy sebaceous material.
- Within the wall, it is common to find tooth structures and areas of calcification.
- On histologic examination, the cyst wall is composed of stratified squamous epithelium with underlying sebaceous glands, hair shafts, and other skin adnexal structures.
- In most cases, structures from other germ layers can be identified, such as cartilage, bone, thyroid tissue, and other organoid formations.
- About 1% of the dermoids undergo malignant transformation of any one of the component elements (e.g., thyroid carcinoma, melanoma, but most commonly, squamous cell carcinoma).
- These tumors arise from an ovum after the first meiotic division.
Monodermal or Specialized Teratomas:
- The most common of the specialized teratoma are struma ovarii and carcinoid.
- They are always unilateral.
- Struma ovarii is composed entirely of mature thyroid tissue. Interestingly, these thyroidal neoplasms may hyperfunction, causing hyperthyroidism.
- The ovarian carcinoid presumably arises from intestinal epithelium in a teratoma and may result in carcinoid syndrome. Primary ovarian carcinoid can be distinguished from metastatic intestinal carcinoid, the latter virtually always bilateral.
- Even more rare is the strumal carcinoid, a combination of struma ovarii and carcinoid in the same ovary.
Immature Malignant Teratomas :
- These are rare tumors that differ from benign teratomas in that the component tissue resembles that observed in the fetus or embryo rather than in the adult.
- The tumor is found chiefly in prepubertal adolescents and young women, mean age being 18 years.
- On microscopic examination, there are varying amounts of immature tissue differentiating toward cartilage, glands, bone, muscle, nerve, and others.
