In the gynecology clinic, 26-year-old girl Xiao Qin showed me the ultrasound results, which showed left ovarian teratoma (5.6*5.5cm in size). After giving her a gynecological examination and a tumor marker test, I told her that she had mature ovarian teratoma.
Ovarian teratoma? Impossible, doctor, I'm not married, I don't have a boyfriend, I've never had sex, how could I get pregnancy tumors? Xiao Qin asked puzzledly.
I told her that although the name of this tumor is ovarian teratoma, it has nothing to do with pregnancy. If
doesn't matter, why do you call it such a misleading name? And is this tumor malignant? Is surgery needed?
I believe Xiao Qin’s problem is also a problem for many female friends who have this kind of tumor. Today, we will popularize science about this gynecological tumor.
Ovarian tumors are common gynecological tumors that can occur at any age. There are many histological types, but they vary at different ages.
Ovarian mature teratoma is part of the ovarian teratoma family. This type of tumor originates from germ cells with totipotent differentiation, and its components include ectoderm, mesoderm and endoderm structures. Ovarian teratoma was described by authors in the 17th century. Because the tumor contains sebum and hair, the name comes from the Greek word monster. Later, different authors found that there were ganglion cells, brain tissue, smooth muscle, thyroid tissue, breast tissue, reproductive organs, teeth, joints, digestive tract tissue, lung remnants and other organ tissues in the tumor.
Because this type of tumor originates from germ cells, it is a tumor produced by germ cells in an abnormal state, and the tumor contains sebum, hair, teeth, smooth muscles, and joints. Does it look like a malformed embryo? So it was named teratoma.
Mature teratomas can occur at any age. They can first appear in newborn babies and can also occur in elderly people aged 80 to 90, but most of them occur in women of childbearing age around 30 years old.
Tumors are mostly unilateral, with similar incidence rates on the left and right sides. Since the tumor is benign, there are often no special symptoms unless complications such as torsion or infection occur. If the tumor twists or ruptures, sudden lower abdominal pain may occur. If the tumor is large, there may be abdominal distension, mild abdominal pain and compression symptoms such as frequent urination.
Ultrasound diagnosis can detect cystoid type, parenchymal type, intracystic dough sign and other manifestations.
Ms. Xiao Qin’s ovarian teratoma has no symptoms at present. She asked me if I can wait and observe without treatment? In this regard, we need to introduce the complications of ovarian teratoma, which are other diseases that may occur with this disease.
Complications:
Torsion: Because tumors often have pedicles, are dense, have a certain weight, and have uneven tumor density, they are prone to torsion. The triggers are often factors that cause sudden changes in abdominal pressure, such as pregnancy, bowel movements, coughing, vomiting, or accidental violence. After torsion occurs, symptoms such as acute abdominal pain, nausea and vomiting are often present.
broken: rare. Rupture occurs mostly due to tumor trauma, torsion, infection or gangrene.
Infection: It can be caused by pelvic inflammatory disease, intestinal adhesions, postpartum and appendiceal abscess.
Malignant transformation: The incidence of malignant transformation of mature teratomas is about 1% to 3%. When the tumor diameter is greater than 10cm, the possibility of malignant transformation is 78% to 86%. Therefore, ovarian teratomas with a diameter greater than 10cm should be operated on as soon as possible to rule out malignant transformation. And a mass diameter less than 10cm does not mean that there is no possibility of malignant transformation.
Treatment
Although mature teratomas are benign tumors, complications such as torsion and infection can occur, and in rare cases there is the possibility of malignant transformation, so surgical treatment is required for treatment. The surgical method should be tumor removal to preserve the normal ovarian tissue of the affected ovary.
Regarding Xiao Qin’s teratoma, I arranged for her to be hospitalized for surgery. The surgical option of choice was laparoscopic ovarian teratoma removal, which has the advantages of less trauma, shorter operation time, and faster recovery. Four days after the operation, Miss Xiao Qin was discharged from the hospital as scheduled.
Literature sources: 1. "Chinese Obstetrics and Gynecology" third edition, editor-in-chief Cao Zeyi.
"Obstetrics and Gynecology" 8th edition, edited by Xie Xing and Gou Wenli.
([Dr. Fu Hong] is the signed author of Toutiao. This article is an original article, first published on Toutiao. The pictures are from the Internet. If you need to reprint, please contact the author of this article, Fu Hong, with the WeChat ID rainbow96_. Due to limited time, this WeChat Signal does not provide patient consultation, please understand)
