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Teratoma
Teratomas are tumors composed of multiple tissue types that arise from embryonic germ cells. They are typically found in the ovaries, testes, sacrococcygeal region, and brain. Mature teratomas contain fully differentiated tissues and are generally benign, while immature teratomas may be cancerous. Sacrococcygeal teratoma is the most common fetal teratoma, occurring in around 1 in 35,000-40,000 births. Prenatal diagnosis allows for treatment planning and improves survival rates. Surgery is the primary treatment for teratomas.
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Introduction to teratomas, abnormal differentiation of fetal germ cells, types, and locations.
Details on mature teratomas, types of cysts, benign nature, and complications associated with dermoid cysts.
Explanation of the Gonzalez-Crussi grading system for teratomas based on maturity and malignancy.
Methods for diagnosing teratomas including ultrasound, MRI, and prevalence of common types.
Specific fetal teratomas statistics, including prevalence, complications, and survival rates.
Discussion on the unique condition of fetiform teratomas and associated theories.
Links to external resources and additional readings on teratomas and related conditions.
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Teratoma
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- 2. Introduction ● due toabnormal differentiation of fetal germ cells that arise from the fetal yolk sac ● Teratomas are typically found in the midline or gonads. Sacrococcygeal - 40% Ovary - 25% Testicle - 12% Brain - 5% Other (including the neck and mediastinum) - 18%
- 3. Introduction Teratomas have beenreported to contain hair, teeth, bone (rarely: eyes,torso,and hands, feet, or other limbs) usually benign mature/benign immature/malignant women men more commonly 95% 5%
- 4. Introduction ● Congenital (unknown:germ cells) ● nonseminomatous germ cell tumor (N.S.G.C.T.) ● abnormal development of pluripotent cells ● germ cells and embryonal cells ● ectoderm, endoderm, and mesoderm germ cells testes or ovaries embryonal cells Congenital unknown
- 5. Mature teratoma ● grade0 teratoma ● solid, cystic, or a combination ● skin, muscle, and bone ● generally benign Dermoid cyst Skin may surround a cyst and grow abundant hair
- 6. Dermoid cyst ● acystic teratoma ● grows slowly and contains mature tissue ● always benign rare malignant in adult: squamous cell carcinoma in infants and children: endodermal sinus tumor
- 7. Dermoid cyst Ovarian dermoidcysts ● totipotential germ cells differentiated abnormally ● Complications: torsion, rupture and infection Periorbital dermoid cysts ● in young children ● near the lateral aspect of the eyebrow ● can recur if not completely excised
- 8. Dermoid cyst Spinal dermoidcysts ● benign ectopic growths of neural tube closure ● lumbosacral region
- 9. Gonzalez-Crussi grading system Grade0 mature (benign) Grade 1 immature, probably benign Grade 2 immature, possibly malignant (cancerous) Grade 3 frankly malignant depends on amount of immature elements <10% 10-50% >50% mature
- 10. Diagnosis ● Prenatal ultrasound ●Prenatal MRI ● “steal syndrome” fetus' blood flow is redirected toward the teratoma ● AFP Some teratomas contain yolk sac elements, which secrete AFP.
- 11. Introduction The most commonlydiagnosed fetal teratomas are sacrococcygeal teratoma (Altman types I, II, and III) and cervical (neck) teratoma.
- 12. Fetal Sacrococcygeal Teratoma ●the most common congenital germ cell tumor ● 1 in 35,000-40,000 ● female predominance (3:1-4:1 ratio) ● prenatally diagnosed: 30-50% ● 36-41% require fetal intervention ● survival rate of prenatally diagnosed SCT is 47-83% ● 50% have long-term morbidity obstructive uropathy, bowel and bladder incontinence http://emedicine.medscape.com/article/2109544-overview#showall
- 13. Cervical teratoma ● 1:20,000-40,000 ●50% presence of calcification ● 20-40% polyhydramnios ● hyper-extended to flexed towards a side ● neonatal airway obstruction http://radiopaedia.org/articles/congenital-cervical-teratoma
- 14. Fetiform teratoma ● Fetusin fetu ● highly developed mature teratomas ● retroperitoneal teratomas Teratoma theory Parasitic twin theory http://en.wikipedia.org/wiki/Fetus_in_fetu anencephalic
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- 18. Treatment ● Surgery non-invasive ofsurrounding tissues ● Chemotherapy for malignant teratomas ● Follow-up
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