page_title: Teratoma
section_title: Diagnosis
hierarchical_section_title: Teratoma / Diagnosis
caption_attribution_description: English: Low magnification micrograph of a mature teratoma. H&amp;E stain. Products of all three germ layers are seen in the image: Mesoderm: immature cartilage (left of image). Endoderm: gastrointestinal lining cells/glands (centre-bottom of image). Ectoderm: epidermis with keratin (right of image). Related images Low mag. Intermed. mag. High mag. Another case: Intermed. mag.
context_page_description: A teratoma is a tumor made up of several different types of tissue, such as hair, muscle, teeth, or bone. They typically form in the ovary, testicle, or coccyx and less commonly in other areas. Symptoms may be minimal if the tumor is small. A testicular teratoma may present as a painless lump. Complications may include ovarian torsion, testicular torsion, or hydrops fetalis.
  They are a type of germ cell tumor. They are divided into two types: mature and immature. Mature teratomas include dermoid cysts and are generally benign. Immature teratomas may be cancerous. Most ovarian teratomas are mature. In adults, testicular teratomas are generally cancerous. Definitive diagnosis is based on a tissue biopsy.
  Treatment of coccyx, testicular, and ovarian teratomas is generally by surgery. Testicular and immature ovarian teratomas are also frequently treated with chemotherapy.
  Teratomas occur in the coccyx in about one in 30,000 newborns, making them one of the most common tumors in this age group. Females are affected more often than males. Ovarian teratomas represent about a quarter of ovarian tumors and are typically noticed during middle age.
context_section_description: Teratomas are thought to originate in utero, so can be considered congenital tumors. Many teratomas are not diagnosed until much later in childhood or in adulthood. Large tumors are more likely to be diagnosed early on. Sacrococcygeal and cervical teratomas are often detected by prenatal ultrasound. Additional diagnostic methods may include prenatal magnetic resonance imaging. In rare circumstances, the tumor is so large that the fetus may be damaged or die. In the case of large sacrococcygeal teratomas, a significant portion of the fetus' blood flow is redirected toward the teratoma (a phenomenon called steal syndrome), causing heart failure, or hydrops, of the fetus. In certain cases, fetal surgery may be indicated.
  Beyond the newborn period, symptoms of a teratoma depend on its location and organ of origin. Ovarian teratomas often present with abdominal or pelvic pain, caused by torsion of the ovary or irritation of its ligaments. A recently discovered condition where ovarian teratomas cause encephalitis associated with antibodies against the N-methyl-D-aspartate receptor antibody (NMDAR) - often referred to as "anti-NMDA receptor encephalitis", was identified as a serious complication. Patients develop a multistage illness that progresses from psychosis, memory deficits, seizures, and language disintegration into a state of unresponsiveness with catatonic features often associated with abnormal movements, and autonomic and breathing instability. Testicular teratomas present as a palpable mass in the testis; mediastinal teratomas often cause compression of the lungs or the airways and may present with chest pain and/or respiratory symptoms.
  Some teratomas contain yolk sac elements, which secrete alpha-fetoprotein. Its detection may help to confirm the diagnosis and is often used as a marker for recurrence or treatment efficacy, but is rarely the method of initial diagnosis. (Maternal serum alpha-fetoprotein is a useful screening test for other fetal conditions, including Down syndrome, spina bifida, and abdominal wall defects such as gastroschisis.)
caption: Micrograph of a teratoma showing tissue from all three germ layers: mesoderm (immature cartilage - left-upper), endoderm (gastrointestinal glands - center-bottom) and ectoderm (epidermis - right)
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