The word teratoma comes from Greek word “Teras”, which has the literal meaning ‘monster’. There are several subtypes of teratoma, ranging from benign to malignant teratoma. Teratoma is a tumor formed by different types of tissues or organs. It is present prior to birth. Depending on the types of cells and the maturity of tumor it can be malevolent. In new- born babies it does not spread usually and is benevolent. On the other hand malevolent teratoma spreads in a hostile way, and other body parts also get affected. Though the tissues of teratoma are regular tissues in themselves but they may be quite dissimilar to the other tissues besides them. Teratoma can contain teeth, hair, bone, and sometimes organs such as limbs, feet, eyes, torso, or hands.
Usually they are germ cells tumors. They normally contain tissues of organs such as lungs, liver, brain, thyroid and are composed of some germ layers. They are usually benign as they are encapsulated. When the teratoma develops fluid filled cyst in its capsule and it enlarges then it usually develop into a structure which is similar to a fetus. Women are more prone to benign teratoma which is mature while men are found to have malignant teratoma which is immature. Even being congenital the small teratoma might not be noticed till quite an age.
What causes teratoma?
Several studies have failed and the actual causes of teratoma are not yet understood by the specialists. It is a birth defect and can also be inherited with defects which affect the lower spine, genitourinary tract, and the central nervous system. There may be other cancers such as Myelodysplasia, Malignant histiocytosis, Acute myelogenous leukemia, and Embryonal rhabdomyosarcoma which may be associated with teratoma. Malignant teratoma is often located in the chest area of young men who are in their 20s-30s.
Symptoms of teratoma
The symptoms of teratoma depend on the size, location, and the individual who has teratoma. The most common symptoms may include the following:
v Swelling, tumor, or mass that is visible and can be felt
v Increases and prominent levels of alpha-fetoprotein
v Increase in the level of beta-human chorionic ganadotropin
v Chest pain and pressure
v Leg weakness and incontinence
v Short breath
v Reduced ability to exercise
Diagnosis of teratoma
The doctors have to carry out some examination physically which can show the veins in the chest centre to be blocked due to the increasing pressure. The following tests can be conducted in the diagnosis of tumor:
v Blood tests are done to check the level of beta-HCG and alpha fetoprotein
v Chest x-ray
v Mediastinoscopy with biopsy
v CT scans of pelvis, chest, and abdomen
Complications with teratoma
Unless there is a vascular steal (huge blood amount flowing through the tumor) or mass effect (the effect of growing mass which tend to result in pathological effects) the teratomas are not risky for the fetus. The vascular steal can affect the growing of the fetus’s heart up to the extent of heart failure and the mass effect hinders the fluid flow from the surrounding organs. The vascular steal should be monitored by fetal echocardiography.
v Surgery: Complete resection is done in the surgical method of treating teratoma. As they are usually separated from the surrounding tissues and encapsulated well, this makes it easy to remove them completely. Teratoma in the brain can be large and complex which makes it difficult to resection the tumor as it is interlaced with the surrounding structures and muscles. Even after surgery the teratoma can be regenerated in the same or the nearby place
v Chemotherapy: Chemotherapy is needed after surgery in case of malignant tumors. Tumors located in inaccessible locations become malignant due to late diagnosis or treatment so they need chemotherapy followed by surgical removal
v Follow-up: Even benign teratoma has the tendency to be malignant. Even after being treated for teratoma the survival rates in infants has been reported from 85%-95% according to some of the studies conducted in UK and Italy. Different tissues involved in teratoma causes different types of secretions with chemicals and systemic effects. These secretions can be useful in detecting the success rate of the treatment and the relapse in patients. Human chorionic gonadotropin is the pregnancy hormone secreted by some teratoma which is used to monitor the success rates but as it is not released by most teratoma, it is not considered as a diagnostic marker. The alpha-fetoprotein can be used as a diagnostic marker under some situations for the yolk sac presence in the teratoma. Its secretion is of marked concern as these cells have the potential to develop into a malignant tumor called as endodermal sinus tumor or yolk sac tumor.