Germ cells have a very remarkable characteristic, that is, they will develop into embryos in the future and can develop into different tissue cells and tissues in other parts of the body. In medicine, they are called "pluripotent stem cells."

Teratoma is a common ovarian tumor, accounting for 10%-20% of all ovarian cysts.

What is teratoma?

There are many tissue types on the ovary, including epithelial cells, germ cells, and mesenchymal cells. Tumors derived from different tissues have different properties. Most ovarian tumors originate from the epithelial tissue on the surface of the ovary and are called ovarian epithelial tumors. If they are malignant, they are called carcinoma.

Teratoma is a tumor derived from the germ cells of the ovary, that is, an egg cell tumor (in males, it is derived from spermatogonia). Germ cells have a very remarkable characteristic, that is, they will develop into embryos in the future and can develop into different tissue cells and tissues in other parts of the body. In medicine, they are called "pluripotent stem cells." When germ cell tumors occur, the tissue is very diverse, and there is not just one type of tumor cell like other tumors.

Therefore, teratoma tumors often contain many tissue components. Hair, bones, fat, brain tissue, etc. can be seen during surgery, so they are named "teratoma" . It is the first time for doctors who have just entered the profession to see teratoma surgery. They will feel a little nauseous and uncomfortable when cutting open the teratoma.

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Is teratoma a parasitic fetus of ?

Teratoma is tumor tissue , not a fetus within a fetus or a parasitic fetus. Many people say that they encapsulated their twin sisters and brothers in their bodies during the embryonic stage. wrong.

Teratoma is a tumor derived from primordial germ cells. Teratomas are not always present at birth.

Do teratomas only exist in the ovaries (gonads)?

Teratomas not only grow in the ovaries and testicles, but also in other parts of the body, such as the brain, thyroid, stomach, sacrococcygeal region, etc. Of course, it is relatively rare, and the most common one is on the ovaries of women. Since teratoma is not a parasitic fetus but a tumor derived from germ cells, how can it grow outside the ovary?

mainly starts from the theory of the origin of teratoma.

One theory is that teratoma is parthenogenesis of primordial germ cells. Under normal circumstances, human reproduction requires the participation of both sexes. If neither an egg cell nor a sperm can complete reproduction, but under abnormal circumstances, parthenogenesis occurs, but it cannot develop into a normal embryo, so it is called a "teratoma".

Another theory is that teratomas originate from primitive germ cells. Germ cells are totipotent. During embryonic development, if the original germ cells remain in inappropriate places and grow uncoordinatedly, they may become teratomas. Therefore, they may exist in other places besides the gonads, mainly in the midline.

The more common teratomas in obstetrics and gynecology are ovarian teratomas, and sacrococcygeal teratomas, which are common in obstetrics and neonates.

Are all ovarian teratomas benign?

Ovarian teratoma is the focus today. Very common ovarian tumors. Because of its distinctive characteristics, it can be diagnosed clearly under ultrasound at a relatively young age. Many people often observe it for a long time after diagnosing teratoma and don't care.

It has no symptoms, does not affect ovarian function, or even affects pregnancy , so it is often not taken seriously.

But not all ovarian teratomas are benign. Generally speaking, we call benign teratomas mature cystic teratomas, while immature teratomas are malignant. Mature abnormalities may also undergo malignant transformation. Mature teratomas in the malignant transformation stage are more malignant and less responsive to chemotherapy. Benign tumors account for the vast majority, about 95-98%, while malignant tumors account for only 2-5%, including primary immature teratomas and malignant transformation of mature teratomas.

What impact does mature cystic ovarian teratoma have on health?

Teratomas generally have no symptoms and are mostly discovered accidentally during physical examination. Small teratomas can only be diagnosed under ultrasound. However, the characteristic of teratoma is that the tumor composition is inconsistent, including bones, hair and fat, so the center of gravity is often biased to one side, which makes teratoma prone to tumor torsion and acute abdominal pain. Ovarian cyst torsion is acute abdomen , manifesting as sudden severe cramping. Many patients do not even know they have teratoma before acute abdomen occurs.

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When ovarian cyst torsion occurs, surgery must be performed as soon as possible. Otherwise, the torsion time will be too long, which will lead to ovarian necrosis. In the end, the ovary cannot be preserved and can only be removed. With timely surgery, the torsioned cyst can be reduced, the blood supply to the ovary can be restored, and the ovary can be preserved.

The ovaries are very important for our young women. They will ovulate to ensure fertility and secrete estrogen to maintain women's youthful status.

For doctors, if the cyst does not undergo surgery and pathology, its nature, especially benign and malignant, cannot be determined. Benign tumors may also become malignant during their growth. Therefore, ovarian teratoma has been diagnosed and surgery should be performed as soon as possible.

How to operate mature cystic ovarian teratoma?

ovarian teratoma, laparoscopic ovarian cyst removal can be considered. Laparoscopy is the first choice. The incision is small and minimally invasive.

For ovarian teratomas, the pelvic condition is generally good, adhesions are less likely to occur, and the operation is not difficult.

However, for any cyst on the ovary, rapid frozen pathology examination should be performed routinely during surgery. to guide doctors in surgery.

Pictures come from the Internet

What are the complications after removal of mature cystic ovarian teratoma? Is it easy to relapse?

Teratoma removal surgery is easier to remove during the operation and causes less damage to the ovaries. It does not affect fertility after the operation and rarely causes decline in ovarian function. This is different from ovarian chocolate cysts. Chocolate cysts themselves will invade normal ovarian tissue and form dense adhesions. Normal ovarian tissue will often be lost during ablation. Therefore, if there are bilateral ovarian cysts, especially those with a long course of disease and large cysts, premature ovarian failure will easily occur after the surgery. Fertility function.

The recurrence probability of teratoma is also lower than that of teratoma. After removal of mature cystic teratomas, no medical treatment is required.

What effects does immature cystic ovarian teratoma have on the body?

Immature teratomas are as metastatic and erosive as other malignant tumors. Ovarian torsion can also occur. Immature teratomas are more likely to rupture, leading to extravasation of cyst fluid and adipose tissue, peritonitis, overlying implantation, and metastasis.

Is it necessary to remove the uterus and ovaries for immature cystic ovarian teratoma?

Immature teratomas are malignant tumors. However, compared with ovarian cancer , it is more likely to occur in young women. It is often found at an early stage, has a good prognosis, and has a high 5-year survival rate. Therefore, if you want to have children, you can keep the uterus and one ovary. That is to say, the reproductive function is preserved. Early stage patients can be observed after surgery, while those in the middle and late stages require chemotherapy.

Those who retain their fertility function should complete childbirth as soon as possible after completing chemotherapy, and if necessary, complete childbirth through assisted reproduction.

Case review

A few years ago, a patient had an ovarian cyst and was diagnosed as a borderline tumor after surgery. Because the patient had not had children, her fertility function was preserved, but the patient kept using the excuse of being busy with business as an excuse not to treat her after surgery. Pregnancy , 2 years later, she is still childless, but the ovarian cyst has recurred, and ultrasound and CT are highly suspicious of ovarian cancer. The child was not born, but the disease worsened. The doctor's decision to preserve the patient's reproductive function is based on comprehensive considerations. In this case, childbirth should be completed as soon as possible, and then a total hysterectomy with double appendages will be performed to prevent future complications.

Patients with immature teratoma who retain their fertility function should be monitored regularly after surgery. Ultrasound, and tumor markers CA125 and AFP. Some immature teratomas may have increased CA125 and AFP.

Older patients who have completed childbearing must undergo comprehensive staging surgery according to the standards for ovarian cancer, which means that the ovaries and uterus cannot be preserved, and the lymph nodes must also be removed. It can provide comprehensive staging and more thorough treatment.

There are standard chemotherapy regimens for immature teratomas, but there is no better chemotherapy regimen for mature teratomas that have become malignant.

Summary

Teratoma is a very common ovarian tumor. There are many mature teratomas. The diagnosis is very easy and the treatment is not complicated. Surgery should be performed promptly upon diagnosis. Mature teratomas are not scary, and immature teratomas are not very scary either. Young patients can retain their reproductive function, complete childbirth as soon as possible after surgery, and need to be reviewed and monitored regularly.After childbearing is completed, both uterine appendages can be removed and a comprehensive staged surgery can be performed.

Teratomas in other parts of the body belong to diseases in different departments, and their diagnosis and treatment have different methods.

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Author introduction

Wang Yuling

Obstetrician and gynecologist Wang Yuling, deputy chief physician of the Department of Assisted Reproduction, Shanghai First Maternal and Infant Health Hospital , has been practicing medicine for 25 years. Specializing in the diagnosis and treatment of female menstrual diseases, infertility, polycystic ovary syndrome, endometriosis and other diseases. A well-known popular science writer on women's health, a self-media contracted author on Sina Weibo and Toutiao, and a columnist in "Women's Weekly" and "National Health and Family Planning Commission Organ Newspaper". Author of popular science bestsellers "Being a Smart Mother-to-be" and "Secrets of the Uterus".

Consultation time: All day on Monday and Wednesday, the expert clinic of the East Hospital welcomes women who are preparing for pregnancy, suffering from polycystic ovary syndrome, endometriosis, etc. to come for consultation.

is good at: diagnosis of infertility, menstrual disorders, amenorrhea, polycystic ovary syndrome, endometriosis, adenomyosis and other diseases.

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