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The teratoma is a type of non-seminomatous germ cell tumour that can lead to several physical conditions including prominent cancerous development, inflammation and abdominal pressure. The physical condition constitutes of germ cell tumour that is formed with varied cells. Benign and malignant are two types of ovarian teratoma that are generally observed among people.
What is Teratoma?
The tumour of teratoma is formed with various kinds of tissue that include bone, muscle or hair. Additionally, the tumours are seen to be formed in tailbone, testicles or ovaries and the symptoms are not found on a large scale only if the size of a tumour is small. Present at birth, the tumour is considered to be congenital; however, the small tumours are not discovered properly at that time.
- Teratoma is classified into three categories that include malignant, immature and mature.
- Immature teratoma has blastemal or neuroectodermal tissue.
- During childhood and teenage period, the physical condition has an epidemiological, pathological, clinical and epidemiological pattern that is linked to biological behaviour.
- Mature teratoma is more prevalent among the population than immature teratoma and sacrococcygeal teratoma is primarily seen among newborn babies and infants.
- Ovarian teratoma is mostly seen to grow among the age group of 15 years.
- Due to the development of the disease, complications can be seen in hydrops fetalis, ovarian torsion or testicular torsion.
The word, teratoma, is derived from Greek that holds the meaning of ‘monstrous tumour’. This is generally found in human beings and only a small rate of species is affected by it. Apart from hair, teeth or bone, development in torso, hands, limb and feet are observed in the arrest cases.
Presence of the organs is not always found but the native or neighbouring tissues of the organs including thyroid, brain, lungs or liver are seen. Few of the large teratoma cases even include a human foetus.
Types of Teratoma
Mature teratoma is mostly benign and mostly women become victims of the abnormalities. Men are the common victims of the immature teratoma. The pathologist makes use of biopsy test to detect the condition.
Now you know where mature teratoma and immature teratomas are found in the human body, apart from these two, there is malignant teratoma that is known as non-seminomatous germ cell tumour abbreviated as NSGCT. This type of condition is formed due to the problems observed in the embryonic and germ cells. They are widely located in the ovaries and testes of female and male patients gradually.
The embryonic teratoma is spotted on midline of patients and general locations are areas in skull, under tongue, internal area of nose and brain. Spotted around the neck area, the existence of cervical teratoma is seen in mediastinum, coccyx and retroperitoneum. You may take a note that the condition is seen in places where there is an only hollow organ and few of the hollow organs are bladder and gastrointestinal tract.
Monodermal teratoma is found to contain only a type of issue and the other types of issues are neural tumours, struma ovarii and carcinoid tumours.
Causes of Teratoma
The tumours of the physical condition start to arise when the benign germ cells change its nature and replicate in an unusual way. The initiation of multiplication of the benign germ cells which lead to the development of various cells hindering functionality of the tissues and cells is the prime cause of the condition.
- The cause of this particular condition is completely understood by the scientists by the certain amount of received problems are linked to a high risk for creating germ cell tumours.
- The tumours lead to malfunctions in several places that include problems in central nervous system, lower spine and genitourinary tract.
- Male patients who have the issue of failure of testes to fall downwards into scrotal sac can develop testicular germ cell tumour. This condition may arise alone; however, influence of genetics cannot be discarded.
- Missing or additional sex chromosomes or unusual development of reproductive organ can be root of the condition.
Teratoma is developed with a single cell and after its cell division and the research scholars have found the parthenogenesis theory by taking help of genetic testing and molecular techniques. The key fundamental of the theory suggests that the tumours are scattered over the migration pattern of primordial germ cells.
Symptoms of Teratoma
Manifold of symptoms is discovered due to the size and location of the tumours in the human body. Moreover, the symptoms and signs even differ from every person to person.
When our body is affected by the nervous system which responds to bodily damage or trauma, a sensation is perceived which can range from being chronic or temporary. Burning, stabbing, dull, achy, sharp or shooting are the common types of pain and in this disease, pain is perceived by almost every patient.
Due to swelling, lump is a protuberance and a raised area which can take form of a tumour, cyst, nodule, bump or contusion. Different reasons are related to its growth and trauma, infections and inflammations are the signs of the development. Hematomas or insect bites might be the cause of the lump; however, the malignant and benign tumours might be perceived as a bump.
Apart from undergoing abdominal pain or discovering lump in body, other signs of the disorder include increased level of beta-human chorionic gonadotropin, swelling or inflammation, high level of alpha-fetoprotein, irregular testicular size, inconsistency or constipation or shortness of breath.
- The symptoms of sacrococcygeal teratoma involved vomiting, abdominal distension, pain and constipation. You should keep in mind that the inner development of a tumour can lead to other complications. In addition to the context, other complicated conditions involve obstruction in urinary
- Symptoms of ovarian teratoma include infertility, abdominal cramping and uterine bleeding.
- Cystic teratoma symptoms are based on the location of a tumour and vaginal bleeding, inflammation and abdominal pain are the general signs.
The extremities of the disease damage eyes and tailbone are the most affected area among the babies. Due to the growth of benign lump, inflammation is seen and malignant tumours grow all over the native organs leading to declining state of the functionality of organs.
Know Diagnosis of Teratoma
Biopsy, complete blood count and other blood tests are the general procedures followed to diagnose the disease.
- Through biopsy, an area of tissue is removed and examined with the help of a microscope.
- By measuring quantity, maturity and size of varied blood cells of a specific amount of blood, complete blood count are
- Magnetic resonance imaging or popularly known as MRI, the medical practitioners decide whether you have teratoma. Radio frequencies, large magnets and computerized process of creating images with intricate details of body structures and organs, the test outcome is found.
- With the help of high-frequency sound waves and a computerised device to produce images of tissues, organs and blood vessels, the procedure of ultrasound or sonography is done. Additionally, a sight of internal organs is received so that the blood flow is assessed easily.
- Assessing kidney and liver functions, running tests on blood chemistries and focusing on genetic studies, the medical professionals find out the prevalence of the disorder.
- Bone scans are done during the diagnostic procedure to find out whether there is any abnormalities have occurred due to the tumours.
- Computed tomography scan is an imaging procedure that combines computer technology and X-rays sp that axial and horizontal images are created. A thorough view of the organs, muscles, fat and bones are received with this procedure and in a way, it can be said this one is a detailed X-rays.
Recent studies have found that the ovarian teratoma exists with abdominal or pelvic discomfort which is later spread due to torsion of the ovary.
Common Treatment for Teratoma
After diagnosing the disease, teratoma is thoroughly monitored and then surgical, chemotherapy and follow-up are treated.
Treatment for Testicular Teratoma
This type of teratoma is conventionally treated by the radical or simple orchiectomy and the traditional excision by enucleation is performed in case of prepubertal teratoma of testis. Many studies have been unable to frame the demonstration of negative consequences for testicular teratoma. Additionally, tests-sparing treatment processes are more suitable.
Tumour spillage and seeding, inadequate sampling, unidentified micro-invasive disease and wrong diagnosis by frozen section are the common risks of this type of teratoma.
- The tumour must be extracted from small rim of normal testicle and due to the changes of testicular tissue; radical inguinal orchiectomy must be performed.
- High ligation of spermatic cord is essentially required for performing radical inguinal orchiectomy as the malignant cases require.
- In case of incision, extension of medial portion of incision towards upper scrotum should be performed in case of large
- If trans-scrotal biopsy is performed before resection, then the tumour must be in phase II. This happens because a wide range of preadolescent tumours responds to chemotherapy. Only in rare cases, hemiscrotectomy is required.
- Ipsilateral retroperitoneal lymph nodes are unnecessary if the images produced during diagnosis period do not show the signs of lymph node enlargement.
- Nodes that have a diameter over 4 cm can be treated as phase III metastatic disorder and in this case, biopsy is not necessary.
With the maturation of testes, the possibility of malignancy increases and children at the puberty stage have high chances of developing the disorder. The procedure of orchiectomy is suggestive only if the frozen section discloses signs of maturity. Sectional or enucleation orchiectomy for teratoma is not suggested for the adults or adolescent population.
Treating Mediastinal Tumour
This type of tumour is treated with the resection through lateral thoracotomy or median sternotomy. By making use of the video-assisted thoracoscopic surgery, it is seen that small amount of unusual damage has been resected. Huge amount of unusual damage might lead to airway compromise and is in need of intubation.
The medical practitioners take help of neoadjuvant chemotherapy, initial biopsy and complete resection later for treating this particular condition. Thymus and pericardium that are known as follower insignificant structures need to be removed along with a tumour simultaneously.
Patients suffering from epithelial ovarian cancer who want to have children in future need to undergo surgery where Fallopian tube and malignant ovary must be removed but not the ovary, uterus and Fallopian tube of the other side can still remain in the female body.
Unfortunately, development of cancer in both of the sides of Fallopian tube leaves no choice for the ones who wish to have children. It is highly recommended to remove both of the ovaries and Fallopian tubes only if the patient is done having children.
In order to keep up ovarian function in the woman’s body, the doctor suggests removing only one part of an ovary. For allowing future pregnancy through the use of in-vitro fertilisation, the patient may consult with the medical professional for keeping the uterus.
The treatments often show adverse effects as chemotherapy is widely used for the treatment procedure. Secondary malignancy, neurotoxicity, nephrotoxicity, myelosuppression, ototoxicity and infertility are the common complications of chemotherapy.
Infertility is the highest risk factor for this treatment procedure and research studies have shown that only one female among twenty-six female patients has been able to become the mother of a child. Additionally, none of the cases of fertilisation resulted in live birth.
Diet and Consultation
It is important for the patients to follow a proper diet at the time of chemotherapy and intestinal obstruction can be one of the usual consequences of abdominal tumour. Parenteral nutrition or nutritional supplement is required on a large scale en bloc enteral tube feeding. In addition to the context, psychological support can be useful to deal with the problem.
Follow-up or long-term monitoring is fruitful for the patients because relapse of the condition can lead to untimely death of the person. MRI or computed tomography can help the doctors to keep a track of the condition of the patients and doctors often may ask you to take tests on a regular basis. Do not hesitate to pay a visit to the doctor if you seen any abnormalities.