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===Pathogenesis===
===Pathogenesis===
*Mature teratoma arises from a pathological transformation of primordial germ cell during the develompment.<ref name="VuralVural2015">{{cite journal|last1=Vural|first1=F.|last2=Vural|first2=B.|last3=Paksoy|first3=N.|title=Vaginal teratoma: A case report and review of the literature|journal=Journal of Obstetrics and Gynaecology|volume=35|issue=7|year=2015|pages=757–758|issn=0144-3615|doi=10.3109/01443615.2015.1004525}}</ref><ref name="El-MaarriRijlaarsdam2015">{{cite journal|last1=El-Maarri|first1=Osman|last2=Rijlaarsdam|first2=Martin A.|last3=Tax|first3=David M. J.|last4=Gillis|first4=Ad J. M.|last5=Dorssers|first5=Lambert C. J.|last6=Koestler|first6=Devin C.|last7=de Ridder|first7=Jeroen|last8=Looijenga|first8=Leendert H. J.|title=Genome Wide DNA Methylation Profiles Provide Clues to the Origin and Pathogenesis of Germ Cell Tumors|journal=PLOS ONE|volume=10|issue=4|year=2015|pages=e0122146|issn=1932-6203|doi=10.1371/journal.pone.0122146}}</ref>
*Mature teratoma arises from a pathological transformation of primordial germ cell during the develompment.<ref name="VuralVural2015">{{cite journal|last1=Vural|first1=F.|last2=Vural|first2=B.|last3=Paksoy|first3=N.|title=Vaginal teratoma: A case report and review of the literature|journal=Journal of Obstetrics and Gynaecology|volume=35|issue=7|year=2015|pages=757–758|issn=0144-3615|doi=10.3109/01443615.2015.1004525}}</ref><ref name="El-MaarriRijlaarsdam2015">{{cite journal|last1=El-Maarri|first1=Osman|last2=Rijlaarsdam|first2=Martin A.|last3=Tax|first3=David M. J.|last4=Gillis|first4=Ad J. M.|last5=Dorssers|first5=Lambert C. J.|last6=Koestler|first6=Devin C.|last7=de Ridder|first7=Jeroen|last8=Looijenga|first8=Leendert H. J.|title=Genome Wide DNA Methylation Profiles Provide Clues to the Origin and Pathogenesis of Germ Cell Tumors|journal=PLOS ONE|volume=10|issue=4|year=2015|pages=e0122146|issn=1932-6203|doi=10.1371/journal.pone.0122146}}</ref>
*Mature teratoma comes from a single germ cell tumor after first phase of meiosis and failure of meiosis type II.<ref name="LinderMcCaw1975">{{cite journal|last1=Linder|first1=David|last2=McCaw|first2=Barbara Kaiser|last3=Hecht|first3=Frederick|title=Parthenogenic Origin of Benign Ovarian Teratomas|journal=New England Journal of Medicine|volume=292|issue=2|year=1975|pages=63–66|issn=0028-4793|doi=10.1056/NEJM197501092920202}}</ref><ref name="pmid2220805">{{cite journal| author=Surti U, Hoffner L, Chakravarti A, Ferrell RE| title=Genetics and biology of human ovarian teratomas. I. Cytogenetic analysis and mechanism of origin. | journal=Am J Hum Genet | year= 1990 | volume= 47 | issue= 4 | pages= 635-43 | pmid=2220805 | doi= | pmc=1683780 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2220805  }} </ref>
*Mature teratoma comes from a single germ cell tumor after first phase of meiosis and failure of meiosis type II.<ref name="LinderMcCaw1975">{{cite journal|last1=Linder|first1=David|last2=McCaw|first2=Barbara Kaiser|last3=Hecht|first3=Frederick|title=Parthenogenic Origin of Benign Ovarian Teratomas|journal=New England Journal of Medicine|volume=292|issue=2|year=1975|pages=63–66|issn=0028-4793|doi=10.1056/NEJM197501092920202}}</ref><ref name="pmid2220805">{{cite journal| author=Surti U, Hoffner L, Chakravarti A, Ferrell RE| title=Genetics and biology of human ovarian teratomas. I. Cytogenetic analysis and mechanism of origin. | journal=Am J Hum Genet | year= 1990 | volume= 47 | issue= 4 | pages= 635-43 | pmid=2220805 | doi= | pmc=1683780 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2220805 }} </ref><ref name="pmid14614249">{{cite journal| author=Caspi B, Lerner-Geva L, Dahan M, Chetrit A, Modan B, Hagay Z et al.| title=A possible genetic factor in the pathogenesis of ovarian dermoid cysts. | journal=Gynecol Obstet Invest | year= 2003 | volume= 56 | issue= 4 | pages= 203-6 | pmid=14614249 | doi=10.1159/000074755 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14614249 }} </ref>
*Mature teratoma contains a well differentiated tumor with all three germ layers (ectoderm, mesoderm and endoderm).<ref name="El-MaarriRijlaarsdam2015">{{cite journal|last1=El-Maarri|first1=Osman|last2=Rijlaarsdam|first2=Martin A.|last3=Tax|first3=David M. J.|last4=Gillis|first4=Ad J. M.|last5=Dorssers|first5=Lambert C. J.|last6=Koestler|first6=Devin C.|last7=de Ridder|first7=Jeroen|last8=Looijenga|first8=Leendert H. J.|title=Genome Wide DNA Methylation Profiles Provide Clues to the Origin and Pathogenesis of Germ Cell Tumors|journal=PLOS ONE|volume=10|issue=4|year=2015|pages=e0122146|issn=1932-6203|doi=10.1371/journal.pone.0122146}}</ref>
*Mature teratoma contains a well differentiated tumor with all three germ layers (ectoderm, mesoderm and endoderm).<ref name="El-MaarriRijlaarsdam2015">{{cite journal|last1=El-Maarri|first1=Osman|last2=Rijlaarsdam|first2=Martin A.|last3=Tax|first3=David M. J.|last4=Gillis|first4=Ad J. M.|last5=Dorssers|first5=Lambert C. J.|last6=Koestler|first6=Devin C.|last7=de Ridder|first7=Jeroen|last8=Looijenga|first8=Leendert H. J.|title=Genome Wide DNA Methylation Profiles Provide Clues to the Origin and Pathogenesis of Germ Cell Tumors|journal=PLOS ONE|volume=10|issue=4|year=2015|pages=e0122146|issn=1932-6203|doi=10.1371/journal.pone.0122146}}</ref>
*Mature teratoma may be located in the embryonic fusion midline or paraxial, mediastinum, ovary, retroperitoneum, and sacrococcygeal.<ref name="pmid8008317">{{cite journal| author=Comerci JT, Licciardi F, Bergh PA, Gregori C, Breen JL| title=Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature. | journal=Obstet Gynecol | year= 1994 | volume= 84 | issue= 1 | pages= 22-8 | pmid=8008317 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8008317  }} </ref>
*Mature teratoma may be located in the embryonic fusion midline or paraxial, mediastinum, ovary, retroperitoneum, and sacrococcygeal.<ref name="pmid8008317">{{cite journal| author=Comerci JT, Licciardi F, Bergh PA, Gregori C, Breen JL| title=Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature. | journal=Obstet Gynecol | year= 1994 | volume= 84 | issue= 1 | pages= 22-8 | pmid=8008317 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8008317  }} </ref>
Line 32: Line 32:
**19
**19
**22q
**22q
==Immunohistochemistry==
*Neuronal element found in mature or immature teratoma are positive for:<ref name="pmid16306792">{{cite journal| author=Yoshikata R, Yamamoto T, Kobayashi M, Ota H| title=Immunohistochemical characteristics of mature ovarian cystic teratomas in patients with postoperative recurrence. | journal=Int J Gynecol Pathol | year= 2006 | volume= 25 | issue= 1 | pages= 95-100 | pmid=16306792 | doi=10.1097/01.pgp.0000172082.17805.6c | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16306792  }} </ref><ref name="TakayamaMatsumura2015">{{cite journal|last1=Takayama|first1=Yoshiyasu|last2=Matsumura|first2=Nozomi|last3=Nobusawa|first3=Sumihito|last4=Ikota|first4=Hayato|last5=Minegishi|first5=Takashi|last6=Yokoo|first6=Hideaki|title=Immunophenotypic features of immaturity of neural elements in ovarian teratoma|journal=Virchows Archiv|volume=468|issue=3|year=2015|pages=337–343|issn=0945-6317|doi=10.1007/s00428-015-1891-8}}</ref>
** [[Glial fibrillary acidic protein]] (GFAP)
** Neuron specific enolase (NSE)
** [[S-100 protein|S-100]]
*Carcinoid tumor found in the monodermal teratoma may be positive for:<ref name="OutwaterSiegelman2001">{{cite journal|last1=Outwater|first1=Eric K.|last2=Siegelman|first2=Evan S.|last3=Hunt|first3=Jennifer L.|title=Ovarian Teratomas: Tumor Types and Imaging Characteristics|journal=RadioGraphics|volume=21|issue=2|year=2001|pages=475–490|issn=0271-5333|doi=10.1148/radiographics.21.2.g01mr09475}}</ref>
** Serotonin and peptides hormones.
==Associated conditions==
==Associated conditions==
Conditions associated with teratoma include:
Conditions associated with teratoma include:
*Anti-NMDA receptor encephalitis<ref name="pmid29245365">Liang Z, Yang S, Sun X, Li B, Li W, Liu Z et al. (2017) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=29245365 Teratoma-associated anti-NMDAR encephalitis: Two cases report and literature review.] ''Medicine (Baltimore)'' 96 (49):e9177. [http://dx.doi.org/10.1097/MD.0000000000009177 DOI:10.1097/MD.0000000000009177] PMID: [https://pubmed.gov/29245365 29245365]</ref><ref name="DalmauGleichman2008">{{cite journal|last1=Dalmau|first1=Josep|last2=Gleichman|first2=Amy J|last3=Hughes|first3=Ethan G|last4=Rossi|first4=Jeffrey E|last5=Peng|first5=Xiaoyu|last6=Lai|first6=Meizan|last7=Dessain|first7=Scott K|last8=Rosenfeld|first8=Myrna R|last9=Balice-Gordon|first9=Rita|last10=Lynch|first10=David R|title=Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies|journal=The Lancet Neurology|volume=7|issue=12|year=2008|pages=1091–1098|issn=14744422|doi=10.1016/S1474-4422(08)70224-2}}</ref><ref name="MalayevAlberts2015">{{cite journal|last1=Malayev|first1=Yuliya|last2=Alberts|first2=Jared|last3=Verardi|first3=Mary Ann|last4=Mattison|first4=Anissa R.|last5=Imlay|first5=Sherwin|title=Immature Teratoma Associated With Anti–N-Methyl-D-Aspartate Receptor Encephalitis|journal=The Journal of the American Osteopathic Association|volume=115|issue=9|year=2015|pages=573|issn=0098-6151|doi=10.7556/jaoa.2015.116}}</ref>
*Anti-NMDA receptor encephalitis<ref name="pmid29245365">Liang Z, Yang S, Sun X, Li B, Li W, Liu Z et al. (2017) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=29245365 Teratoma-associated anti-NMDAR encephalitis: Two cases report and literature review.] ''Medicine (Baltimore)'' 96 (49):e9177. [http://dx.doi.org/10.1097/MD.0000000000009177 DOI:10.1097/MD.0000000000009177] PMID: [https://pubmed.gov/29245365 29245365]</ref><ref name="DalmauGleichman2008">{{cite journal|last1=Dalmau|first1=Josep|last2=Gleichman|first2=Amy J|last3=Hughes|first3=Ethan G|last4=Rossi|first4=Jeffrey E|last5=Peng|first5=Xiaoyu|last6=Lai|first6=Meizan|last7=Dessain|first7=Scott K|last8=Rosenfeld|first8=Myrna R|last9=Balice-Gordon|first9=Rita|last10=Lynch|first10=David R|title=Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies|journal=The Lancet Neurology|volume=7|issue=12|year=2008|pages=1091–1098|issn=14744422|doi=10.1016/S1474-4422(08)70224-2}}</ref><ref name="MalayevAlberts2015">{{cite journal|last1=Malayev|first1=Yuliya|last2=Alberts|first2=Jared|last3=Verardi|first3=Mary Ann|last4=Mattison|first4=Anissa R.|last5=Imlay|first5=Sherwin|title=Immature Teratoma Associated With Anti–N-Methyl-D-Aspartate Receptor Encephalitis|journal=The Journal of the American Osteopathic Association|volume=115|issue=9|year=2015|pages=573|issn=0098-6151|doi=10.7556/jaoa.2015.116}}</ref>
==Gross and microscopy pathology==
==Gross and microscopy pathology==
The gross and microscopy features of teratoma are described below:<ref name="Yayla AbideBostancı Ergen2018">{{cite journal|last1=Yayla Abide|first1=Çiğdem|last2=Bostancı Ergen|first2=Evrim|title=Retrospective analysis of mature cystic teratomas in a single center and review of the literature|journal=Journal of Turkish Society of Obstetric and Gynecology|volume=15|issue=2|year=2018|pages=95–98|issn=1307699X|doi=10.4274/tjod.86244}}</ref><ref name="OutwaterSiegelman2001">{{cite journal|last1=Outwater|first1=Eric K.|last2=Siegelman|first2=Evan S.|last3=Hunt|first3=Jennifer L.|title=Ovarian Teratomas: Tumor Types and Imaging Characteristics|journal=RadioGraphics|volume=21|issue=2|year=2001|pages=475–490|issn=0271-5333|doi=10.1148/radiographics.21.2.g01mr09475}}</ref><ref name="Ulbright2005">{{cite journal|last1=Ulbright|first1=Thomas M|title=Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues|journal=Modern Pathology|volume=18|issue=S2|year=2005|pages=S61–S79|issn=0893-3952|doi=10.1038/modpathol.3800310}}</ref><ref name="pmid29798962">{{cite journal| author=Varma AV, Malpani G, Agrawal P, Malukani K, Dosi S| title=Clinicopathological spectrum of teratomas: An 8-year retrospective study from a tertiary care institute. | journal=Indian J Cancer | year= 2017 | volume= 54 | issue= 3 | pages= 576-579 | pmid=29798962 | doi=10.4103/ijc.IJC_294_17 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29798962  }} </ref>
The gross and microscopy features of teratoma are described below:<ref name="Yayla AbideBostancı Ergen2018">{{cite journal|last1=Yayla Abide|first1=Çiğdem|last2=Bostancı Ergen|first2=Evrim|title=Retrospective analysis of mature cystic teratomas in a single center and review of the literature|journal=Journal of Turkish Society of Obstetric and Gynecology|volume=15|issue=2|year=2018|pages=95–98|issn=1307699X|doi=10.4274/tjod.86244}}</ref><ref name="OutwaterSiegelman2001">{{cite journal|last1=Outwater|first1=Eric K.|last2=Siegelman|first2=Evan S.|last3=Hunt|first3=Jennifer L.|title=Ovarian Teratomas: Tumor Types and Imaging Characteristics|journal=RadioGraphics|volume=21|issue=2|year=2001|pages=475–490|issn=0271-5333|doi=10.1148/radiographics.21.2.g01mr09475}}</ref><ref name="Ulbright2005">{{cite journal|last1=Ulbright|first1=Thomas M|title=Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues|journal=Modern Pathology|volume=18|issue=S2|year=2005|pages=S61–S79|issn=0893-3952|doi=10.1038/modpathol.3800310}}</ref><ref name="pmid29798962">{{cite journal| author=Varma AV, Malpani G, Agrawal P, Malukani K, Dosi S| title=Clinicopathological spectrum of teratomas: An 8-year retrospective study from a tertiary care institute. | journal=Indian J Cancer | year= 2017 | volume= 54 | issue= 3 | pages= 576-579 | pmid=29798962 | doi=10.4103/ijc.IJC_294_17 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29798962 }} </ref><ref name="pmid12432104">{{cite journal| author=Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST| title=CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. | journal=Radiographics | year= 2002 | volume= 22 | issue= 6 | pages= 1305-25 | pmid=12432104 | doi=10.1148/rg.226025033 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12432104  }} </ref><ref name="pmid26379326">{{cite journal| author=da Silva TK, Ribeiro GJ, Scortegagna FA, Zanetti G, Marchiori E| title=Teratoma: a set of teeth in the pelvis. | journal=Radiol Bras | year= 2015 | volume= 48 | issue= 4 | pages= 263-4 | pmid=26379326 | doi=10.1590/0100-3984.2015.0034 | pmc=4567366 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26379326  }} </ref><ref name="pmid30150913">{{cite journal| author=Rathore R, Sharma S, Agarwal S| title=Malignant transformation in mature cystic teratoma of the ovary: a retrospective study of eight cases and review of literature. | journal=Prz Menopauzalny | year= 2018 | volume= 17 | issue= 2 | pages= 63-68 | pmid=30150913 | doi=10.5114/pm.2018.77304 | pmc=6107092 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30150913  }} </ref><ref name="pmid5100397">{{cite journal| author=Caruso PA, Marsh MR, Minkowitz S, Karten G| title=An intense clinicopathologic study of 305 teratomas of the ovary. | journal=Cancer | year= 1971 | volume= 27 | issue= 2 | pages= 343-8 | pmid=5100397 | doi=10.1002/1097-0142(197102)27:2<343::aid-cncr2820270215>3.0.co;2-b | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5100397  }} </ref><ref name="pmid4722922">{{cite journal| author=Wisniewski M, Deppisch LM| title=Solid teratomas of the ovary. | journal=Cancer | year= 1973 | volume= 32 | issue= 2 | pages= 440-6 | pmid=4722922 | doi=10.1002/1097-0142(197308)32:2<440::aid-cncr2820320222>3.0.co;2-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4722922  }} </ref><ref name="pmid9264351">{{cite journal| author=Moran CA, Suster S| title=Primary germ cell tumors of the mediastinum: I. Analysis of 322 cases with special emphasis on teratomatous lesions and a proposal for histopathologic classification and clinical staging. | journal=Cancer | year= 1997 | volume= 80 | issue= 4 | pages= 681-90 | pmid=9264351 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9264351  }} </ref><ref name="pmid30256256">{{cite journal| author=Kao CS, Bangs CD, Aldrete G, Cherry AM, Ulbright TM| title=A Clinicopathologic and Molecular Analysis of 34 Mediastinal Germ Cell Tumors Suggesting Different Modes of Teratoma Development. | journal=Am J Surg Pathol | year= 2018 | volume= 42 | issue= 12 | pages= 1662-1673 | pmid=30256256 | doi=10.1097/PAS.0000000000001164 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30256256 }} </ref>


{| class="wikitable"
{| class="wikitable"
Line 47: Line 54:
!Mature teratoma
!Mature teratoma
|
|
*Unilateral solid mass in most cases
*Unilateral cystic mass in most cases, rarely solid
*Predominantly cystic with hair tufts, teeth, and cartilaginous material
*Predominantly cystic with hair tufts, teeth, and cartilaginous material
*Unilocular in most cases
*Unilocular in most cases
*Capsular compoment is well defined
*Soft, tan, measured about 3 to 21 cm in diameter
|
|
*Squamous epithelium (skin)
*Contains three embryonic layers (misoderm, endoderm, and ectoderm)
*Keratinized squamous cells epithelium
*Adnexal structures (sebaceous glands, hair follicles)
*Adnexal structures (sebaceous glands, hair follicles)
*Adipose tissues
*Adipose tissues
*Lobules of mature cartilage
*Glands lined by the respiratry mucosa and digestive mucosa
*Skeletal muscles
*No cytology atypia
*No cytology atypia
|
|
Line 59: Line 72:
![[Immature teratoma]]
![[Immature teratoma]]
|
|
* Solid mass with necrotic and hemorrhagic areas
*Solid mass with necrotic and hemorrhagic areas
 
*Cystic cavities may be filled with serous or mucinous fluid
*  
*Capsular is not well defined
*  
*Tends to be larger than mature cystic teratoma
|
|
*  
*Neural tissues with neuroepithelial rosettes
*  
*Choroid plexus
*  
*Immature mesenchymal
*
*Presence of primtive elements
*  
*Cytology atypia
*  
*  
|  
|  
Line 75: Line 88:
![[Monodermal teratoma]]
![[Monodermal teratoma]]
|
|
*  
*Unilateral mass
*  
*Well differentiated neoplasm
*  
*  
|
|

Latest revision as of 09:58, 17 November 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2]

Overview

The histopathology of teratoma depends on the histological subtype.Teratoma is a germ cell tumor due to abnormal development of pluripotent cells and renmant of primitive node.

Pathophysiology

 
 
 
 
 
 
 
Germ cell
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pathogenesis
 
 
 
 
 
 
 
Malignant transformation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mature teratoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
{{{ }}}
 
Tumors with primitive embryonic ectoderm, mesoderm, and/or endoderm differentiation{{{ }}}
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
{{{ }}}
 
 
 
 
 
 
 
 
 
 
 
Immature teratoma
 

Pathogenesis

  • Mature teratoma arises from a pathological transformation of primordial germ cell during the develompment.[1][2]
  • Mature teratoma comes from a single germ cell tumor after first phase of meiosis and failure of meiosis type II.[3][4][5]
  • Mature teratoma contains a well differentiated tumor with all three germ layers (ectoderm, mesoderm and endoderm).[2]
  • Mature teratoma may be located in the embryonic fusion midline or paraxial, mediastinum, ovary, retroperitoneum, and sacrococcygeal.[6]
  • Immature teratoma may be due to the malignant tranformation of primitive germ cell layers and renmant of primive node.[7][8]

Genetics

Genes involved in the pathogenesis of teratoma include:[9]

  • Gain of part or all chromosomes
    • 1p
    • 16p
    • 19
    • 22q

Immunohistochemistry

  • Neuronal element found in mature or immature teratoma are positive for:[10][11]
  • Carcinoid tumor found in the monodermal teratoma may be positive for:[12]
    • Serotonin and peptides hormones.

Associated conditions

Conditions associated with teratoma include:

Gross and microscopy pathology

The gross and microscopy features of teratoma are described below:[16][12][17][7][18][19][20][21][22][23][24]

Types Gross pathology Microscopic pathology Images
Mature teratoma
  • Unilateral cystic mass in most cases, rarely solid
  • Predominantly cystic with hair tufts, teeth, and cartilaginous material
  • Unilocular in most cases
  • Capsular compoment is well defined
  • Soft, tan, measured about 3 to 21 cm in diameter
  • Contains three embryonic layers (misoderm, endoderm, and ectoderm)
  • Keratinized squamous cells epithelium
  • Adnexal structures (sebaceous glands, hair follicles)
  • Adipose tissues
  • Lobules of mature cartilage
  • Glands lined by the respiratry mucosa and digestive mucosa
  • Skeletal muscles
  • No cytology atypia
Immature teratoma
  • Solid mass with necrotic and hemorrhagic areas
  • Cystic cavities may be filled with serous or mucinous fluid
  • Capsular is not well defined
  • Tends to be larger than mature cystic teratoma
  • Neural tissues with neuroepithelial rosettes
  • Choroid plexus
  • Immature mesenchymal
  • Presence of primtive elements
  • Cytology atypia
Monodermal teratoma
  • Unilateral mass
  • Well differentiated neoplasm




References

  1. ↑ Vural, F.; Vural, B.; Paksoy, N. (2015). "Vaginal teratoma: A case report and review of the literature". Journal of Obstetrics and Gynaecology. 35 (7): 757–758. doi:10.3109/01443615.2015.1004525. ISSN 0144-3615.
  2. ↑ 2.0 2.1 El-Maarri, Osman; Rijlaarsdam, Martin A.; Tax, David M. J.; Gillis, Ad J. M.; Dorssers, Lambert C. J.; Koestler, Devin C.; de Ridder, Jeroen; Looijenga, Leendert H. J. (2015). "Genome Wide DNA Methylation Profiles Provide Clues to the Origin and Pathogenesis of Germ Cell Tumors". PLOS ONE. 10 (4): e0122146. doi:10.1371/journal.pone.0122146. ISSN 1932-6203.
  3. ↑ Linder, David; McCaw, Barbara Kaiser; Hecht, Frederick (1975). "Parthenogenic Origin of Benign Ovarian Teratomas". New England Journal of Medicine. 292 (2): 63–66. doi:10.1056/NEJM197501092920202. ISSN 0028-4793.
  4. ↑ Surti U, Hoffner L, Chakravarti A, Ferrell RE (1990). "Genetics and biology of human ovarian teratomas. I. Cytogenetic analysis and mechanism of origin". Am J Hum Genet. 47 (4): 635–43. PMC 1683780. PMID 2220805.
  5. ↑ Caspi B, Lerner-Geva L, Dahan M, Chetrit A, Modan B, Hagay Z; et al. (2003). "A possible genetic factor in the pathogenesis of ovarian dermoid cysts". Gynecol Obstet Invest. 56 (4): 203–6. doi:10.1159/000074755. PMID 14614249.
  6. ↑ Comerci JT, Licciardi F, Bergh PA, Gregori C, Breen JL (1994). "Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature". Obstet Gynecol. 84 (1): 22–8. PMID 8008317.
  7. ↑ 7.0 7.1 Varma AV, Malpani G, Agrawal P, Malukani K, Dosi S (2017). "Clinicopathological spectrum of teratomas: An 8-year retrospective study from a tertiary care institute". Indian J Cancer. 54 (3): 576–579. doi:10.4103/ijc.IJC_294_17. PMID 29798962.
  8. ↑ Keene DJ, Craigie RJ, Shabani A, Batra G, Hennayake S (2011). "Bipartite anterior extraperitoneal teratoma: evidence for the embryological origins of teratomas?". Case Rep Med. 2011: 208940. doi:10.1155/2011/208940. PMC 3163403. PMID 21949666.
  9. ↑ Kraggerud SM, Szymanska J, Abeler VM, Kaern J, Eknaes M, Heim S et al. (2000) DNA copy number changes in malignant ovarian germ cell tumors. Cancer Res 60 (11):3025-30. PMID: 10850452
  10. ↑ Yoshikata R, Yamamoto T, Kobayashi M, Ota H (2006). "Immunohistochemical characteristics of mature ovarian cystic teratomas in patients with postoperative recurrence". Int J Gynecol Pathol. 25 (1): 95–100. doi:10.1097/01.pgp.0000172082.17805.6c. PMID 16306792.
  11. ↑ Takayama, Yoshiyasu; Matsumura, Nozomi; Nobusawa, Sumihito; Ikota, Hayato; Minegishi, Takashi; Yokoo, Hideaki (2015). "Immunophenotypic features of immaturity of neural elements in ovarian teratoma". Virchows Archiv. 468 (3): 337–343. doi:10.1007/s00428-015-1891-8. ISSN 0945-6317.
  12. ↑ 12.0 12.1 Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). "Ovarian Teratomas: Tumor Types and Imaging Characteristics". RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.
  13. ↑ Liang Z, Yang S, Sun X, Li B, Li W, Liu Z et al. (2017) Teratoma-associated anti-NMDAR encephalitis: Two cases report and literature review. Medicine (Baltimore) 96 (49):e9177. DOI:10.1097/MD.0000000000009177 PMID: 29245365
  14. ↑ Dalmau, Josep; Gleichman, Amy J; Hughes, Ethan G; Rossi, Jeffrey E; Peng, Xiaoyu; Lai, Meizan; Dessain, Scott K; Rosenfeld, Myrna R; Balice-Gordon, Rita; Lynch, David R (2008). "Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies". The Lancet Neurology. 7 (12): 1091–1098. doi:10.1016/S1474-4422(08)70224-2. ISSN 1474-4422.
  15. ↑ Malayev, Yuliya; Alberts, Jared; Verardi, Mary Ann; Mattison, Anissa R.; Imlay, Sherwin (2015). "Immature Teratoma Associated With Anti–N-Methyl-D-Aspartate Receptor Encephalitis". The Journal of the American Osteopathic Association. 115 (9): 573. doi:10.7556/jaoa.2015.116. ISSN 0098-6151.
  16. ↑ Yayla Abide, Çiğdem; Bostancı Ergen, Evrim (2018). "Retrospective analysis of mature cystic teratomas in a single center and review of the literature". Journal of Turkish Society of Obstetric and Gynecology. 15 (2): 95–98. doi:10.4274/tjod.86244. ISSN 1307-699X.
  17. ↑ Ulbright, Thomas M (2005). "Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues". Modern Pathology. 18 (S2): S61–S79. doi:10.1038/modpathol.3800310. ISSN 0893-3952.
  18. ↑ Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST (2002). "CT and MR imaging of ovarian tumors with emphasis on differential diagnosis". Radiographics. 22 (6): 1305–25. doi:10.1148/rg.226025033. PMID 12432104.
  19. ↑ da Silva TK, Ribeiro GJ, Scortegagna FA, Zanetti G, Marchiori E (2015). "Teratoma: a set of teeth in the pelvis". Radiol Bras. 48 (4): 263–4. doi:10.1590/0100-3984.2015.0034. PMC 4567366. PMID 26379326.
  20. ↑ Rathore R, Sharma S, Agarwal S (2018). "Malignant transformation in mature cystic teratoma of the ovary: a retrospective study of eight cases and review of literature". Prz Menopauzalny. 17 (2): 63–68. doi:10.5114/pm.2018.77304. PMC 6107092. PMID 30150913.
  21. ↑ Caruso PA, Marsh MR, Minkowitz S, Karten G (1971). "An intense clinicopathologic study of 305 teratomas of the ovary". Cancer. 27 (2): 343–8. doi:10.1002/1097-0142(197102)27:2<343::aid-cncr2820270215>3.0.co;2-b. PMID 5100397.
  22. ↑ Wisniewski M, Deppisch LM (1973). "Solid teratomas of the ovary". Cancer. 32 (2): 440–6. doi:10.1002/1097-0142(197308)32:2<440::aid-cncr2820320222>3.0.co;2-8. PMID 4722922.
  23. ↑ Moran CA, Suster S (1997). "Primary germ cell tumors of the mediastinum: I. Analysis of 322 cases with special emphasis on teratomatous lesions and a proposal for histopathologic classification and clinical staging". Cancer. 80 (4): 681–90. PMID 9264351.
  24. ↑ Kao CS, Bangs CD, Aldrete G, Cherry AM, Ulbright TM (2018). "A Clinicopathologic and Molecular Analysis of 34 Mediastinal Germ Cell Tumors Suggesting Different Modes of Teratoma Development". Am J Surg Pathol. 42 (12): 1662–1673. doi:10.1097/PAS.0000000000001164. PMID 30256256.

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