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| | __NOTOC__ |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| {{Infobox_Disease |
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| Name = {{PAGENAME}} |
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| Image = Teratoma congenital.jpg|
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| Caption = Congenital teratoma. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small> |
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| DiseasesDB = 3604 |
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| DiseasesDB_mult = {{DiseasesDB2|12952}} {{DiseasesDB2|12966}} |
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| ICD10 = |
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| ICD9 = |
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| ICDO = 9080 |
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| OMIM = |
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| MedlinePlus = |
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| MeshID = D013724 |
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| }}
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| {{Teratoma}} | | {{Teratoma}} |
| {{CMG}} | | {{CMG}} |
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| ==[[Teratoma historical perspective|Historical Perspective]]== | | ==[[Teratoma historical perspective|Historical Perspective]]== |
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| | ==[[Teratoma classification|Classification]]== |
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| ==[[Teratoma pathophysiology|Pathophysiology]]== | | ==[[Teratoma pathophysiology|Pathophysiology]]== |
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| ==[[Teratoma epidemiology and demographics|Epidemiology & Demographics]]== | | ==[[Teratoma causes|Causes]]== |
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| | ==[[Teratoma differential diagnosis|Differentiating Teratoma from other Diseases]]== |
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| | ==[[Teratoma epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==[[Teratoma risk factors|Risk Factors]]== | | ==[[Teratoma risk factors|Risk Factors]]== |
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| ==[[Teratoma screening|Screening]]== | | ==[[Teratoma screening|Screening]]== |
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| ==[[Teratoma causes|Causes]]==
| | ==[[Teratoma natural history|Natural History, Complications and Prognosis]]== |
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| ==[[Teratoma differential diagnosis|Differentiating Teratoma]]==
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| ==[[Teratoma natural history|Complications & Prognosis]]== | |
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| ==Diagnosis== | | ==Diagnosis== |
| [[Teratoma history and symptoms|History and Symptoms]] | [[Teratoma physical examination|Physical Examination]] | [[Teratoma staging|Staging]] | [[Teratoma laboratory tests|Laboratory tests]] | [[Teratoma electrocardiogram|Electrocardiogram]] | [[Teratoma x ray|X Rays]] | [[Teratoma CT|CT]] | [[Teratoma MRI|MRI]] [[Teratoma echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Teratoma other imaging findings|Other images]] | [[Teratoma other diagnostic studies|Alternative diagnostics]] | | [[Teratoma history and symptoms|History and Symptoms]] | [[Teratoma physical examination|Physical Examination]] | [[Teratoma staging|Staging]] | [[Teratoma laboratory tests|Laboratory Findings]] | [[Teratoma chest x ray|Chest X Ray]] | [[Teratoma CT|CT]] | [[Teratoma MRI|MRI]] | [[Teratoma echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Teratoma other imaging findings|Other Imaging Findings]] | [[Teratoma other diagnostic studies|Other Diagnostic Studies]] |
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| ==Treatment==
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| [[Teratoma medical therapy|Medical therapy]] | [[Teratoma surgery|Surgical options]] | [[Teratoma primary prevention|Primary prevention]] | [[Teratoma secondary prevention|Secondary prevention]] | [[Teratoma cost-effectiveness of therapy|Financial costs]] | [[Teratoma future or investigational therapies|Future therapies]]
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| ==Complications==
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| Teratomas are not dangerous for the fetus unless there is either a [[mass effect (medicine)|mass effect]] or a large amount of blood flow through the tumor (known as ''vascular steal''). The mass effect frequently consists of obstruction of normal passage of fluids from surrounding organs. The vascular steal can place a strain on the growing heart of the fetus, even resulting in heart failure, and thus must be monitored by fetal [[echocardiography]].
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| After surgery, there is a risk of regrowth in place, or in nearby organs.<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=14532748 ''A recurred case of a mature ovarian teratoma presenting as a rectal mass'' (in Korean, abstract in English)]</ref>
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| ==Treatment== | | ==Treatment== |
| ===Surgery===
| | [[Teratoma medical therapy|Medical Therapy]] | [[Teratoma surgery|Surgery]] | [[Teratoma primary prevention|Primary Prevention]] | [[Teratoma secondary prevention|Secondary Prevention]] | [[Teratoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Teratoma future or investigational therapies|Future or Investigational Therapies]] |
| The treatment of choice is complete surgical removal (i.e., complete resection).<ref>[http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=6684416 ''Teratomas in infancy and childhood. A 54-year experience at the Children's Hospital Medical Center'' Tapper and Lack (1983) Ann Surg. 198(3): 398–410]</ref><ref>[http://annonc.oxfordjournals.org/cgi/reprint/11/3/263 ''Germ-cell tumors in childhood and adolescence. GPOH MAKEI and the MAHO study groups'' Göbel et al (2000) Ann Oncol. 11(3): 263-271]</ref> Teratomas normally are well encapsulated and non-invasive of surrounding tissues, hence they are relatively easy to resect from surrounding tissues. Exceptions include teratomas in the brain, and very large, complex teratomas that have pushed into and become interlaced with adjacent muscles and other structures.
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| Prevention of recurrence does not require ''en bloc'' resection of surrounding tissues.
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| ===Chemotherapy===
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| For malignant teratomas, usually, surgery is followed by chemotherapy.
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| Teratomas that are in surgically inaccessible locations, or are very complex, or are likely to be malignant (due to late discovery and/or treatment) sometimes are treated first with chemotherapy.
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| ===Clinical trials===
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| There are now (2007) two [[clinical trials]] in progress that address [[germ cell tumors]], both of which include teratomas.<ref>[http://www.stjude.org/search/0,2616,582_3161_18009,00.html GCT1P1 Protocol / Clinical Study: Pilot study of Cisplatin, Etoposide, Bleomycin and Escalating Dose Cyclophosphamide Therapy for Children with High-Risk Malignant Germ Cell Tumors]</ref><ref>[http://www.stjude.org/search/0,2616,582_3161_10572,00.html GCT132 Protocol / Clinical Study: A Phase III Study of Reduced Therapy in the Treatment of Children with Low and Intermediate Risk Extracranial Germ Cell Tumors (AGCT0132)]</ref>
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| ===Follow-up===
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| Depending on which tissue(s) it contains, a teratoma may secrete a variety of chemicals with systemic effects. Some teratomas secrete the "pregnancy hormone" [[human chorionic gonadotropin]] (βhCG), which can be used in clinical practice to monitor the successful treatment or relapse in patients with a known HCG-secreting teratoma. This hormone is not recommended as a diagnostic marker, because most teratomas do not secrete it. Some teratomas secrete [[thyroxine]], in some cases to such a degree that it can lead to clinical [[hyperthyroidism]] in the patient. Of special concern is the secretion of [[alpha-fetoprotein]] (AFP); under some circumstances AFP can be used as a diagnostic marker specific for the presence of [[yolk sac]] cells within the teratoma. These cells can develop into a frankly malignant tumor known as [[yolk sac tumor]] or [[endodermal sinus tumor]].
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| '''Adequate follow-up''' requires close observation, involving repeated physical examination, scanning (ultrasound, MRI, or CT), and measurement of AFP and/or βhCG.<ref name="pmid10561269">{{cite journal
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| | author = Marina NM, Cushing B, Giller R, Cohen L, Lauer SJ, Ablin A, Weetman R, Cullen J, Rogers P, Vinocur C, Stolar C, Rescorla F, Hawkins E, Heifetz S, Rao PV, Krailo M, Castleberry RP
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| | title = Complete surgical excision is effective treatment for children with immature teratomas with or without malignant elements: A Pediatric Oncology Group/Children's Cancer Group Intergroup Study. | |
| | journal = J. Clin. Oncol.
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| | volume = 17
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| | issue = 7
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| | pages = 2137-43
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| | year = 1999
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| | pmid = 10561269
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| | doi =
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| | issn =
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| }}</ref><ref name="pmid10454682">{{cite journal
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| | author = Cushing B, Giller R, Ablin A, Cohen L, Cullen J, Hawkins E, Heifetz SA, Krailo M, Lauer SJ, Marina N, Rao PV, Rescorla F, Vinocur CD, Weetman RM, Castleberry RP
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| | title = Surgical resection alone is effective treatment for ovarian immature teratoma in children and adolescents: a report of the pediatric oncology group and the children's cancer group.
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| | journal = Am. J. Obstet. Gynecol.
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| | volume = 181
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| | issue = 2
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| | pages = 353-8
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| | year = 1999
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| | pmid = 10454682
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| | doi =
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| | issn =
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| }}</ref>
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| ==Use in basic research==
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| In light of the [[Stem cell controversy|ethical issues surrounding the source of human stem cells]], teratomas are being looked at as an alternative source for research since they lack the potential to grow into functional human beings.
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| ==References== | | ==Case Study== |
| {{Reflist|2}}
| | [[Teratoma case study one|Case #1]] |
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| ==See also== | | ==See also== |
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| Tumor pages for locations in which teratoma can occur: | | Tumor pages for locations in which teratoma can occur: |
| *[[Brain tumor|Brain]] | | *[[Brain tumor|Brain]] |
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| *[[Testicular cancer|Testicles]] | | *[[Testicular cancer|Testicles]] |
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| Other conditions that may resemble a teratoma:
| | ==Related Chapters== |
| *[[Pilonidal cyst]] in humans | | *[[Pilonidal cyst]] in humans |
| | * [[Dermoid cyst]] |
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| ===Technical information===
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| *[http://www.orpha.net//consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=883 Orphanet page on teratoma]
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| *[http://www.emedicine.com/med/topic2248.htm EMedicine article on cystic teratoma] (also [http://www.emedicine.com/cgi-bin/foxweb.exe/searchengine@/em/searchengine?boolean=and&book=all&maxhits=100&HiddenURL=&query=teratoma search EMedicine for all articles containing the word ''teratoma''])
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| *[http://www.nytimes.com/2006/06/06/health/06tera.html Monster Tumors Show Scientific Potential in War Against Cancer] article in the New York Times
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| {{SIB}}
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| {{Tumors}} | | {{Tumors}} |
| {{Soft tissue tumors and sarcomas}} | | {{Soft tissue tumors and sarcomas}} |
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| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
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