Teratoma

Teratoma

Teratomas are tumor-like structures that are relatively rare and still terrify many people today because of their strange appearance. Most of them are benign tumors.

What are teratomas?

Teratomas are congenital growths that contain one or more rudimentary tissue structures. They arise from the germ cells (stem cells) of the ovaries and testicles and are usually localized there. However, they can also occur elsewhere (central nervous system, neck, coccyx, abdominal region, brain). For what does cda stand for, please visit ezhoushan.net.

Teratomas located in the testicles are malignant, while those located in the ovaries are usually benign. Teratomas are usually unilateral. They can arise from only one germ layer (dermoid cysts) or from several germ layers. Dermoid cysts contain only skin tissue, sebum and sweat glands, and hair follicles. If the tumors consist of the cells of several germ layers, they still have teeth, muscle tissue and other structures.

Such differentiated forms are also called mature teratomas. However, the immature ones (malignant teratomas) often contain only embryonic epithelial tissue. The majority of germ cell tumors arise from ectodermal and neuroectodermal tissue and develop into skin, hair, sweat and sebaceous glands, and neural tissue. Much less common are mesodermal forms with bone, muscle, teeth and endodermal teratomas. They are endowed with rudimentary thyroid, pancreas and pituitary tissue.

In very rare cases, the cysts even contain entire organs (hands, feet, eyes) or a structure resembling a malformed fetus (homunculus). Germ cell tumors are usually cysts with a cavity filled with yellow sebum or mucus. There are also solid teratomas. They are completely filled with tissue.

Causes

The reason for the development of teratomas is probably that during the development of the embryo in the womb, embryonic stem cells become independent and settle elsewhere in the body. However, science assumes that abducted germ cells can also become teratomas.

This can happen, for example, during an operation or if the adult injures himself: the tissue is accidentally torn out and grows again in another place, where it gradually expands. However, the term “twin ulcer” that is sometimes used to describe the teratoma is misleading: a teratoma is not a rudimentary twin in its brother’s/sister’s body, as it consists of embryonic stem cells and not sex cells.

Symptoms, Ailments and Signs

Symptoms and the discovery of the teratoma usually do not occur until adulthood. Sometimes, however, teratomas of considerable size are discovered in infants. The nature of the symptoms depends on where the germ cell tumor is located and what size it has already developed.

With teratomas in the abdomen, the affected person notices an increase in abdominal circumference. If they are further down, the lower abdomen bulges. There may be problems with urination and bowel movements. If the swelling presses on nerves due to its growing expansion or pushes organs aside, there is an increased feeling of pressure and pain. This can be the case, for example, with a dermoid cyst.

Malignant teratomas enlarge faster and even grow into neighboring organs. This can also lead to an irregular menstrual cycle. A torsion of the stem or a rupture of the capsule causes extreme abdominal pain and can even be life-threatening if the contents of the tumor empty into the abdominal cavity and cause peritonitis there. In rare cases, bleeding into the abdomen and detachment of the tumor can also occur.

Teratomas, located in the brain, are associated with chronic headaches, dizziness, and symptoms typical of common brain tumors. If the teratomas in the ovary contain a high proportion of thyroid tissue, this can lead to hyperthyroidism in the patient (ovarian goiter). About one percent of germ cell tumors later become malignant.

Diagnosis and course of the disease

Abdominal teratomas are identified by palpation of the affected area. In order to be sure what exactly is involved, an ultrasound and, if necessary, an X-ray examination is carried out. If the teratoma contains calcareous substances such as teeth, the doctor can already know at this stage of the examination what type of germ cell tumor is present.

However, he only obtains complete certainty through a tissue removal, which is carried out under local anesthesia. A tiny piece of tissue is removed from the affected area and examined histologically. Blood tests show a strong increase in the tumor markers bHCG, AFP and/or LDH. Most teratomas are not diagnosed with certainty until they are fairly large and causing symptoms.

Complications

A teratoma can cause a variety of symptoms. Above all, the exact position and size is very important for the complications and symptoms. Those affected primarily suffer from problems with bowel movements and urination. This can cause burning or pain in general. Many of those affected suffer from psychological problems or depression.

Irregularities in women’s periods and thus mood swings can also occur in women due to illness. Sometimes abdominal pain occurs and the peritoneum itself can become inflamed. Furthermore, those affected by the teratoma suffer from severe dizziness and a malfunction of the thyroid gland. This usually has a very negative effect on health and may also reduce the life expectancy of the patient.

In most cases, a teratoma requires surgery. The growth can be removed. There are no complications. However, some patients are dependent on chemotherapy, which can lead to side effects. After successful treatment, no further complaints occur.

When should you go to the doctor?

If swelling or general irregularities in body shape are observed in newborns and infants, the observations should be discussed with a doctor. A teratoma causes optical changes in the genital area. Males show swelling of the testicles and females have growths in the ovaries. If abnormalities are found in these body regions, you must consult a doctor immediately.

Since in most cases the first irregularities appear in adulthood, a doctor is needed as soon as the congenital disorder is noticed. Irregularities when going to the toilet, abnormalities when urinating or problems with bowel movements are signs of health problems. They should be examined and treated.

If young girls or women experience menstrual cycle disorders or unusually severe abdominal pain, a doctor is needed. If boys or men notice optical irregularities in their testicles, they should also see a doctor. Headaches, dizziness or unsteady gait can also indicate a teratoma. If you develop hoarseness, problems swallowing or problems with your coccyx, you should consult a doctor. Disturbances in concentration, loss of memory, inconsistencies in coordination or general functional disorders must be examined by a doctor as soon as possible.

Treatment & Therapy

Treatment of the teratoma depends on whether it is benign or malignant – which is determined by the tissue sample taken. If it is benign, surgically removing it completely is sufficient. For this purpose, the ovaries are excised using a laparoscopy.

If a malignant teratoma is present, not only the actual tumor but also the affected neighboring tissue and the nearby lymph nodes are removed. In men, the affected testicle is removed. This is followed by a cisplatin-based chemotherapeutic treatment. The prognosis in such cases is favorable. However, the malignant teratomas that occur in some girls and young women usually respond negatively to chemotherapy or radiation therapy.

Prevention

Prevention is not possible because teratomas arise spontaneously.

Aftercare

If the teratoma has been surgically removed, it depends on the patient’s condition how long they have to stay in the hospital afterwards. The extent of the germ cell tumor plays a decisive role. Other important factors are the location of the teratoma and the general health of the patient.

If it is only a small teratoma, such as a dermoid in a woman’s ovary, an outpatient removal is often sufficient, so that the patient can then return home. In most cases, those affected have to stay in the clinic for one to three days after the operation, which is usually performed as a laparoscopy.

However, if a teratoma is more extensive, it requires a more complex procedure such as an abdominal incision, which increases the length of the hospital stay. Patients often stay in the hospital for up to a week. Babies or young children who have had a coccyx interatoma surgically removed may also need to stay in the hospital for a few days, although the length of time varies. Sometimes chemotherapy is given afterwards.

Because a teratoma can recur despite successful treatment, which is usually the case after two to five years, regular follow-up care in the form of check-ups is recommended. Among other things, a computed tomography or an X-ray chest examination is carried out in order to detect a possible recurrence at an early stage and to treat it accordingly.

You can do that yourself

Benign teratomas are surgically removed. After a surgical procedure, the usual measures apply. Recovery can be assisted by adequately caring for and caring for the wound. If symptoms occur again that indicate a recurrence, the doctor must be informed. Further treatment may be necessary.

Teratoma patients should consult their GP closely, as a teratoma can cause hormonal problems. Sweating and psychological complaints indicate an influence on the hormonal balance and must be treated accordingly in order to avoid serious complaints and complications. Exercise and avoiding stress also help with recovery. Especially after major operations, which also represent a psychological burden, a balance must be created.

Those affected should also contact a self-help group. Friends and acquaintances provide additional support in the event of cancer. In the case of malignant teratomas, the body is heavily burdened by the chemotherapy and appropriate countermeasures are necessary. Sport and a diet plan are important components of the accompanying treatment. The doctor will consult other doctors for this purpose and urge the patient to strictly comply with the measures.

Teratoma