A Teratoma is a germ cell tumor derived from pleuripotential cells and they are made up of elements of different kinds of tissue of any or more than one of the three germ cell layers. The tissues may be normal themselves but are different from surrounding tissues and are disparate. Teratoma has tissues from hair, bone, teeth and complex organs such as eyes, torso, and hands, feet, or other limbs. They are very often found in the ovaries or testes, the rare tumor of the neck and the head region arises mainly from the Rathke’s pouch remnants of the sphenoid bone, from the lateral neck and the tongue.
The most tissue kinds found in this tumor are mature but full differentiation is lacking. They are mixed together admixed showing little or no connection with the normal anatomical positions. They are usually encapsulated from the surroundings and is margined from the surrounding tissues. Malignant tumor occurs but it contains a single component showing dysplastic change.
Teratomas are classified according to the Gonzalez-Crussi grading system as follows:
- 0 or mature
- 1 or immature probably benign
- 2 or immature, possibly malignant
- 3 or frankly malignant
If tumor is frankly malignant it’s a tumor. Grade 0 tumor has the risk of malignancy while Grade 1 tumor has much higher risk of malignancy and requires adequate follow up.
A teratoma with malignant transformation is a rare condition that contains elements of somatic malignant tumors such as leukemia or carcinoma or sarcoma.
This tumor shows a lot of symptoms. Some of them are
- On palpation and examination there is presence of lump showing probabilities of the tumor
- Due to this tumor the patient usually experiences pain, which is one of the chief symptoms of any tumor.
- Due to presence of tumor, lump, there may be signs of inflammation due to the bits of the tumor tissue.
- The tumor which presents as lump on examination shows tenderness on examination. The area of suspected tumor is felt hard when we try to press the tumor area.
- Due to presence of lump and tenderness and inflammation, there is swelling of the tissues which are involved in the tumor.
These are generally seen symptoms of a patient presenting this tumor. The patient presenting these symptoms should be taken into serious account and diagnosis done as early as possible to prevent further complications.
Generally teratomas are present from birth and hence can be considered as congenital tumors. But they are not diagnosed until late childhood or adulthood. They are diagnosed by prenatal ultrasound. Other methods used for diagnosis are Magnetic Resonance Imaging. Some tumors contain yolk sac elements which secrete alpha-feto protein (AFP). Detection of AFP may confirm the diagnosis and is used as a tumor marker for diagnosis.
Treatment of choice includes surgery involving complete removal of tumor. They are generally well encapsulated and hence easy to operate on. Surgery is followed by appropriate chemotherapy. Adequate follow up should be done for the treatment of this tumor.
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