Types of Ovarian Tumors: Mature Teratoma

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.