2023-06-07 17:37:17
Although it is a benign tumor in most cases, a teratoma can lead to serious symptoms, such as urinary incontinence or constipation. What is this tumor? We tell you regarding it here.
Teratoma is a type of tumor that develops from pluripotent stem cells. The term comes from the Greek: teratos means ‘monster’, and the suffix – own, ‘tumor’. Literally, this term means monstrous tumor.
It is so named because of its bizarre appearance. It can contain hair, teeth, muscles, bones, among other tissues. Pluripotent stem cells are those that can give rise to all types of cells and tissues; their structures can therefore develop.
Most tumors of this type are benign. However, they can sometimes lead to complications due to their size or location. In rare cases, they become malignant. Below we tell you what the main characteristics of these tumors are and how they are treated.
What is a teratoma?
A teratoma is a type of tumour. All are congenital, i.e. they are present from birth.
These tumors are formed from germ cells. More specifically, from pluripotent stem cells.
This means that cells from all germ layers of the embryo can grow inside. For this reason, they are often made up of different types of tissue, such as hair, teeth, bone or even cartilage.
Teratomas tend to be located in the ovaries in women or in the testicles in men. However, they can appear in the central nervous system, chest, abdomen, or even the coccygeal bone.
Most are benign. Therefore, these tumors generally do not produce distant metastases. However, although less common, they can sometimes be malignant and spread aggressively, damaging surrounding tissue.
Types of teratoma
Teratomas can be classified into different types. Most of the time, they are distinguished according to whether they are benign or malignant. They can also be classified according to their location. We explain this in the following sections.
Mature or benign teratoma
The mature or benign teratoma is one that is formed by mature cells, as its name suggests. It is slow growing, although it can reach a large size. So much so that, although its average size varies between 5 and 15 centimeters, it can measure 45 centimeters.
The most common is in the ovary. To be more precise, in the right ovary. Despite this, it can also be found in the skull, mediastinum, sacrococcygeal region, among others.
When it occurs in the ovary, it is called dermoid cyst. It is usually diagnosed in women of childbearing age and is one of the most common ovarian tumors. Despite its benign nature, it can lead to complications if the woman becomes pregnant.
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Immature or malignant teratoma
Immature or malignant teratoma, unlike the previous one, is potentially carcinogenic. Fortunately, its incidence is much lower. It usually occurs in young people.
In men, it is detected between the ages of 20 and 40. Women usually develop it before the age of 20.
It is composed of immature and atypical cells. Depending on the degree of atypia and the extent of the tumor, it can be classified into different degrees of severity.
Its other characteristics are as follows:
- He is solid.
- Inside there are usually foci of necrosis (that is, dead cells)
- It includes immature tissues, such as connective tissue or even brain tissue.
The prognosis for this type of tumor is very variable. Aggressive treatment, such as removal of the ovary or testicle, may be necessary.
According to location
Depending on where the teratoma grows, it is given one name or another. The most common are sacrococcygeal and ovarian teratomas.
Sacrococcygeal teratomas can present in two different ways. These are most often large benign tumors. These tend to protrude from the sacral area. Therefore, it is common for them to be detected during pregnancy by ultrasound. Otherwise, they are easy to observe following delivery.
The other type is a small tumor located in front of the sacrum. This type makes the baby’s bottom somewhat asymmetrical. If this tumor is not treated, it can damage the child’s bladder or bowel as it develops.
Ovarian teratomas are usually benign. Most are detected on examination for another reason, as they are usually asymptomatic.
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Symptoms
Symptoms of teratomas are highly variable. They depend above all on the location and size of the tumour. Moreover, in the case of children, the interpretation of the symptoms or their way of expressing them are different in each one.
In some cases, it is possible that the tumor can be palpated or even detected through the skin. When located near the sacrum, it is common for it to put pressure on the bowel or bladder.
This is why constipation, urinary incontinence or alterations in the strength of the extremities are among the symptoms. However, as already mentioned above, many cases are asymptomatic.
It should be noted that teratomas cause certain analytical alterations. In the case of tumors composed of germ cells, it is possible that the hormones typical of immature tissues may increase. For example, elevated levels of alpha-fetoprotein or human chorionic gonadotropin are often observed.
What can cause the appearance of a teratoma?
Teratoma is a tumor that develops from germ cells. These cells are the ones that give rise to the tissues that make up the reproductive system. They are usually located in the gonads, that is to say in the ovaries in women and in the testicles in men.
However, a small percentage occurs outside of these organs. Therefore, it is possible that they have an extragonadal localization. The truth is that the exact mechanism by which they develop is not known. Some scientists believe that some germ cells accidentally migrate to other parts of the body.
Usually these cells die. However, in the case of teratomas, this mechanism fails. These cells continue to divide, giving rise to the tumour.
In the particular case of sacro-coccygeal teratomas, it seems that they come from a specific area under the coccyx. This area is called Henson’s knotan area in which germ cells predominate.
Although the exact cause of teratomas is not known, they are often associated with other hereditary defects. For example: abnormalities of the urinary system, the lower part of the spine or defects of the central nervous system.
Diagnosis and treatment
The diagnosis of teratomas can be made in different ways. As mentioned, sometimes a mass is observed or felt, which leads to suspicion. In some cases, a prenatal ultrasound is sufficient. However, other complementary tests are usually needed to confirm the diagnosis.
One of the most used is the blood test. Imaging tests, such as magnetic resonance imaging and computed tomography, are particularly helpful. X-rays can also help. Either way, confirmation is made by biopsy.
Treatment for teratoma also varies depending on the symptoms and the type of tumor. If the tumor is benign, but affects nearby organs, surgical removal is then usually necessary.
In the case where it is a malignant teratoma, in addition to surgery, other more aggressive treatments are necessary. For example: chemotherapy and radiotherapy. Hemotherapy can also be used, which interferes with the ability of cancer cells to grow.
Treatments and recommendations
Teratomas require a series of care when detected in a child. Typically, follow-up visits are done every six months or every year. The objective is to detect early any recurrence or possible complications of the tumour.
During these visits, the child will likely need to undergo a thorough physical examination. Imaging tests and blood tests to check for any abnormalities are also usually ordered.
What you must remember
A teratoma is a tumor made up of germ cells. These are cells that can give rise to any type of tissue. Most tumors are benign, but they are not free from causing complications. It is therefore essential to establish an early diagnosis and an exhaustive follow-up.
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