There is a certain type of germ cell tumor that contains different kinds of cells and it is called a Teratoma. These tumors can be considered a form of birth defect since they are already present at birth. Teratoma is a Greek word that means “monstrous tumor”. These tumors are a jumbled mass of different types of germ cells. They can be located in places on the body where these cells would not otherwise be. Teratomas can contain teeth, bone, hair, fingernail, eye, and organ cells, etc. These tumors may be visible during ultrasound examinations during pregnancy. Some teratomas can be removed while the embryo is still in the womb.
A true teratoma will have all three layers of germ cells. These are the cells that can divide and become anything in the body such as internal organs, hands, fingers, skin, nails etc. However, the teratomas only contain the tissues of these body parts and they do not function. This is a mass of cells can grow rapidly and begin to cause all kinds of symptoms. Teratomoas are usually benign but there are several forms of malignant teratomas too. These types of tumors are normally mature and occur more frequently in females when they are benign. The malignant ones are usually immature teratomas and are found more often in males than in females.
Teratomas are normally surgically removed and then examined by a pathologist for a definitive diagnosis. If the tumor is found to be malignant then chemotherapy and radiation treatment is given to prevent the tumors re-growth. The outcome for a patient who has a malignant teratoma depends on the location of the tumor and if it has spread to other organs in the body.
Sacrococcygeal teratomas are the most common kind found in newborns. They occur in 1 per 20,000-40,000 births. These tumors can be diagnosed through ultra sound tests. When the teratoma is not seen on the ultra sound it can be discovered after birth, usually protruding from the sacral area. These tumors usually occur on the tailbone. Some newborns may have the tumor growing into the pelvis area. Sacrococcygeal teratomas should be removed in the first week of life.
A testicular teratoma can occur in children but it is rare. When found in children they are usually benign. Testicular teratomas in adults and adolescents are usually malignant. Only about 3% of the teratomas that occur after puberty are pure teratomas that have the 3 layers of germ cells. Testicular teratomas are usually painless and appear as a firm or hard scrotal mass. However, in some cases there may be pain and swelling. These tumors can be treated by a simple or radical orchiectomy, which is the removal of the testicles. A more conservative approach is becoming the treatment of choice which is excision of the tumor through a partial orchiectomy. This procedure is usually done pre puberty. The tumor should be completely removed. The risk of it becoming malignant increases as it matures. A partial orchiectomy is not recommended for someone who has a testicular teratoma after puberty.
An ovarian teratoma is a mature tumor in or on the ovary. These types of tumors are usually found during abdominal surgery, a physical exam or radiology. An ovarian teratoma can cause constant and varying degrees of abdominal pain, abnormal uterine bleeding and a swelling or mass in the abdomen. An acute rupture may occur and is common with this type of tumor. There may also be back pain, bladder problems and gastrointestinal disturbances associated with an ovarian teratoma. A teratoma on the ovaries may be removed by simple cystectomy.