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Teratoma

A teratoma is a type of tumor that derives from pluripotent germ cells. The word comes from a Greek term meaning roughly "monster tumor". Teratomas (more correctly teratomata) usually start from cells in the testes in men, the ovaries in women and in the sacrum in children. Teratomata involve cells from all three germ layers: ectoderm, mesoderm, and endoderm. They can be benign or malignant. more...

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Teratomata often contain well-differentiated cells which can result in tissues growing in a teratoma which are quite different from the surrounding tissue—ovarian teratomata have been known to grow hair and teeth. Such a benign cystic teratoma is often termed a dermoid cyst, nowadays more correctly termed a mature teratoma. Some teratomata may contain a mixture of well-differentiated, mature tissues as: respiratory epithelium, hair follicle, fat tissue or mature nervous tissue. Immature teratomata of the ovary have a malignant potential in line with the amount of neuroblastic tissue present.

Testicular teratomata are generally less well-differentiated, and have a worse prognosis (chances of recovery are not as high).

Some teratomata secrete the "pregnancy hormone" human chorionic gonadotropin (HCG), which can be used in clinical practice to follow-up successful treatment or relapse in patients with a known HCG-secreting teratoma. It is not recommended as a diagnostic marker.

Some teratomata secrete thyroxine, in some cases to such a degree that it can lead to clinical hyperthyroidism in the patient.

Struma ovarii

Struma ovarii (literally: goiter of the ovary) is a rare specialized type of teratoma present in the ovary that contains benign thyroid tissue. To be classified as a struma ovarii, thyroid tissue must be the predominant histology. Malignant transformation of struma ovarii is rare, occurring in only 5% of cases.

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Teratoma
From Ear, Nose & Throat Journal, 2/1/05 by Lester D.R. Thompson

Teratomas are neoplasms made up of tissues foreign to the site of occurrence. They contain tissue from all three embryonic germ layers (endoderm, mesoderm, and ectoderm). Other terms--choristoma, hamartoma, heterotopia, epignathus, and dermoid--refer to separate, unique entities that are not covered here.

Only about 6% of all teratomas occur in the head and neck. Patients range in age from newborns to those in their 9th decade, although most patients are neonates and infants. Many of these patients are born prematurely, and their births are often complicated by polyhydramnios. Teratomas are distributed equally between the sexes. Interestingly, neonates have benign tumors, while malignant tumors are seen only in adults. The anatomic site of involvement varies (e.g., neck, sinonasal tract, or nasopharynx). Most patients present with a midline mass lesion and a facial deformity, which are often accompanied by other associated symptoms (e.g., respiratory distress, dyspnea, stridor, or difficulty swallowing). Other congenital anomalies may be present, especially in neonatal patients.

Macroscopically, these tumors are well-circumscribed, lobulated, soft, and cystic. Islands of gritty material consistent with bone and cartilage are often identified. These tumors contain a wide array of mature and immature tissues interspersed with one another. Squamous epithelium, respiratory epithelium, glandular epithelium, gastrointestinal epithelium, thyroid gland, pancreas, liver, neural tissue, pigmented retinal anlage, immature neuroblastomal elements, cartilage, bone, muscle, fat, and loose myxoid-to-fibrous embryonic mesenchymal connective tissue are identified (figures 1 and 2). If the entire tumor is made up of predominantly immature elements, a malignant teratoma or teratocarcinosarcoma must be excluded.

[FIGURES 1-2 OMITTED]

Complete surgical excision is curative, although complications and death may occur secondary to the space-occupying and destructive character of these benign neoplasms.