Types of Ovarian Tumors: Mature Teratoma

by Carlo Raj, MD

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    00:01 Let’s go ahead and talk about that mature teratoma.

    00:04 A cystic neoplasm made up of tissue elements from two or more embryonic layer.

    00:10 In other words, we’re talking about a tumor in which it’s a driving your different germ layers, mesoderm, ectoderm, endoderm.

    00:18 You can see skin, hair, bone, all kinds of issues.

    00:21 The most common type of germ cell tumor in a female.

    00:24 Female.

    00:25 The most common germ cell tumor in a male, once again, I sound like a broken record, seminoma.

    00:31 Also known as dermoid cyst.

    00:33 I would know both names, absolutely know both names.

    00:36 A mature teratoma in a female tends to be benign whereas teratoma in a male will be malignant.

    00:43 That’s important.

    00:44 What does that mean? Next step of management.

    00:47 If it’s a teratoma that you would find in a testicle, you just resect it.

    00:52 That’s your next step, surgery, resection.

    00:54 Do not waste time conducting further investigation.

    00:59 Whereas if with the female, maybe perhaps you want to do grading.

    01:01 So there is a little bit of followup and such as necessary.

    01:07 10 to 15% of these tend to be bilateral.

    01:09 1% may then go onto malignant transformation.

    01:12 Usually, it will be squamous cell cancer.

    01:16 The subtypes of teratoma will contain only thyroid.

    01:19 That’s interesting.

    01:21 Our topic here, we did endocrinology and we did thyroid.

    01:25 There is struma ovarii.

    01:27 So you have a teratoma here.

    01:28 T – teratoma – will produce T3, T4.

    01:35 Notice I did not say TSH.

    01:38 So there might be actual thyroid tissue in the ovarian teratoma, directly producing T3 or T4.

    01:47 You tell me, does that behave like primary or secondary hyperthyroidism? Very good.

    01:54 Primary.

    01:55 If it’s a directly producing T3 and T4 with struma ovarii, you’d expect the TSH levels to be low, just as you would with primary.

    02:05 Always unilateral would be struma ovarii.

    02:08 Make sure you know this subtype.

    02:09 Make sure you know the name and what it’s doing.

    02:14 A mature cystic teratoma, upon gross examination, maybe it’s combing its hair.

    02:19 Maybe it’s giving you a wink You know maybe it’s smiling at you.

    02:22 So this is a tumor that produces every single type of tissue, cartilage, retina, maybe hair.

    02:29 Get the point.

    02:31 Upon your histologic examination, you would expect to find different types of histology because you might have derivation from ectoderm, endoderm, mesoderm.

    02:43 An immature malignant teratoma.

    02:47 You’d find this to be interesting.

    02:48 Immature teratoma known as a dermoid cyst is almost always benign.

    02:54 Immature.

    02:55 Our topic here is im-mature.

    02:58 Automatically going to malignancy, these patients are found prepubertal, adolescents and young women.

    03:04 Varying amounts of immature tissue, differentiation towards cartilage, gland, bone, muscle, nerves.

    03:10 Yes, you can have different types in both.

    03:12 But this tends to be more confusing or more abundant of all kinds of tissue.

    03:19 And more importantly, this is malignant.

    03:22 Immature tissue.

    03:23 Immature.

    03:25 We have a dysgerminoma next.

    03:27 A dysgerminoma is equivalent to a seminoma in a male.

    03:32 Extremely important.

    03:33 A tumor consisting of large cells with clear cytoplasm and well-defined borders.

    03:39 Dysgerminoma.

    About the Lecture

    The lecture Types of Ovarian Tumors: Mature Teratoma by Carlo Raj, MD is from the course Ovarian Diseases.

    Included Quiz Questions

    1. Immature teratoma
    2. Mature teratoma
    3. Dermoid cyst
    4. Struma ovarii
    5. Cystic adenoma
    1. It is always unilateral.
    2. It behaves like secondary hyperthyroidism.
    3. T3/T4 levels are likely to be decreased.
    4. TSH levels are likely to be elevated.
    5. It is a type of epithelial cell tumor.
    1. In men, they are most often benign.
    2. One percent will undergo malignant transformation, usually squamous cell carcinoma.
    3. In women, they are most often benign.
    4. They contain at least 2 embryonic layers.
    5. Ten percent to 15% are bilateral.
    1. Large cells with clear cytoplasm and well-defined borders
    2. A solid tumor composed of endometrial-like glands
    3. Cystic tumor filled with mucinous/gelatinous material
    4. Cystic tumor filled with at least 2 or 3 embryological layers
    5. Cystic tumor lined by tall, columnar epithelial cells

    Author of lecture Types of Ovarian Tumors: Mature Teratoma

     Carlo Raj, MD

    Carlo Raj, MD

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