What Is a Mature Teratoma?

Ovarian mature teratomas are part of the family of ovarian teratomas. They originate from germ cells with totipotent differentiation function. Their components include ectoderm, mesoderm, and endoderm structures. Ovarian mature teratomas can be divided into solid mature teratomas and cystic mature teratomas. The former is very rare and more common in young women. The surface of the tumor is smooth, and the cut surface is solid. There may be honeycomb sacs, and the germ layer tissues in the tumor are all mature. There is no primitive nervous tissue component, and the prognosis is good. The latter is the most common benign tumor of the ovary, so it is also called benign cystic teratoma or dermoid cyst. Mature tissues containing two or more germ layers are mainly derived from ectoderm. Its incidence is high, second only to ovarian serous cystadenomas. Can occur at any age, more common in women of childbearing age. Mainly manifested as lower abdominal pain, abdominal mass and abnormal uterine bleeding.

Basic Information

Visiting department

Obstetrics and Gynecology

Multiple groups

Women of childbearing age

Common causes

Related to factors such as abnormal differentiation of embryonic germ cells

Common symptoms

No complications such as torsion or infection, often without special symptoms

Causes of ovarian mature teratoma

The majority of mature teratomas show a normal karyotype (46, XX), and a very small number of teratomas can be trisomy or triploid.

Clinical manifestations of mature ovarian teratoma

It can occur at any age, and most of it occurs in women of childbearing age around 30 years old. Children and adolescents most often occur after the age of five, with cases concentrated in the 6-11 age group, and teratomas often occur in the palatal region. Tumors are mostly unilateral, with similar incidences on the left and right, and are benign. There are no complications such as torsion or infection, and there are often no special symptoms. Larger tumors cause abdominal distension, mild abdominal pain, and compression symptoms. Combined pregnancy: It is the most common type of pregnancy with ovarian tumors. Very rarely, there are signs of luteinization due to luteinization in the ovarian stroma of the tumor.

Ovarian mature teratoma test

General inspection

Most of them are unilateral, with similar incidences on the left and right, but most are 5 to 15 cm. The mass was round, oval, or lobulated, with a smooth surface and an intact capsule. The cut surface is mostly a large capsule containing hair and sebaceous matter. There are often solid or cystic protruding head nodules on the inner wall of the sac. Hair and teeth are on the surface of the head nodule; bone, cartilage, and adipose tissue are visible on the cut surface.

2. Inspection under the microscope

Often accompanied by foreign body giant cell reactions. The outer wall of the capsule is the ovarian stroma, and the inner wall is lined with skin, hair and skin accessories. Head nodules often show multiple tissues of 3 germ layers.

3. Ultrasound diagnosis

(1) Reflective light clusters appear in the sac inside the capsule. Most of them are circular and can be pasted on the inner wall. There was no echo behind the light group.

(2) The capsule type is mostly round or oval, with thicker capsule walls and mostly single rooms, with dense and reflective light spots inside. Sometimes a thin layer of liquid zone can be seen on the inner wall.

(3) In the capsule, a circular light cluster can be seen in the capsule, with a crescent-shaped reflective light echo above it, attenuated at the rear with obvious sound and shadow.

(4) The stratified sign of lipid fluid in the sac The upper lipids reflect light intensity and dense light spot echo. The bottom clear liquid, or a few light spots floating in the liquid. Between the two layers is a layer of fat liquid.

(5) The structure of the complex capsule is complicated, and there may be two or more of the above types.

4.X-ray diagnosis

There are grease-like substances in the tumor, bones and tooth shadows such as teeth and bone fragments, and calcification of the capsule contents. There are sebaceous substances and hair in the tumor with reduced transparency or a round or oval shadow with a clear outline.

5. Other

Tumor marker examination, laparoscopy.

Ovarian Mature Teratoma Treatment

Laparotomy

Tumor ablation should be taken to preserve the normal tissue of the affected ovary.

(1) Method : Make a shallow incision below the thinnest part of the ovarian envelope, and continue to dissect the tumor when the level under the envelope is correct. After the tumor was removed, the remaining normal ovarian tissue was overlapped and sutured. Ovarian tumors found in early pregnancy: wait until about 4 months of pregnancy before surgery. Tumors were found in late pregnancy and the tumors have been pushed outside the pelvis without obstructing the birth canal: surgical resection of the tumor was performed postpartum. Tumors are found in late pregnancy and tumors obstruct the birth canal: Caesarean section is performed during full-term pregnancy or after labor, and the tumor is removed at the same time.

(2) Precautions to avoid contamination of the abdominal cavity with tumor contents. For patients with unilateral mature teratoma, contralateral ovarian dissection should be performed during surgery. During the dissection, care should be taken not to cut too deep in the portal of the ovary, so as to avoid excessive ligation due to excessive bleeding there and affect ovarian blood flow.

2. Laparoscopic surgery

Incision, separation and hemostasis were performed with an electric knife.

(1) Advantages Postoperative pain and blood loss are reduced; hospitalization days are shortened, and hospitalization costs are reduced.

(2) Disadvantages The thermal effect of electrocautery will have short-term or long-term effects on the structure and function of the ovary; it may extend the operation time and increase the cost of surgery; there is a risk of delay in treatment of patients with ovarian malignant tumors; the contents of teratoma spill into the abdominal cavity Can cause postoperative chemical peritonitis.

(3) Precautions When cystic contents overflow during surgery, rinse with a large amount of physiological saline until the rinse solution becomes clear.