Teratoma: Difference between revisions

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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]]
[[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]]
==Treatment==
==Treatment==
===Surgery===
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.
Prevention of recurrence does not require ''en bloc'' resection of surrounding tissues.


===Chemotherapy===
===Chemotherapy===
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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>
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>
===Follow-up===
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]].
'''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
| 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
| 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.
| volume = 17
| issue = 7
| pages = 2137-43
| year = 1999
| pmid = 10561269
| doi =
| issn =
}}</ref><ref name="pmid10454682">{{cite journal
| 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
| 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.
| journal = Am. J. Obstet. Gynecol.
| volume = 181
| issue = 2
| pages = 353-8
| year = 1999
| pmid = 10454682
| doi =
| issn =
}}</ref>


==Use in basic research==
==Use in basic research==

Revision as of 15:53, 18 January 2012

For patient information click here

Teratoma
Congenital teratoma.
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology
ICD-O: 9080
DiseasesDB 3604 Template:DiseasesDB2 Template:DiseasesDB2
MeSH D013724

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.

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Chemotherapy

For malignant teratomas, usually, surgery is followed by chemotherapy.

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.

Clinical trials

There are now (2007) two clinical trials in progress that address germ cell tumors, both of which include teratomas.[1][2]

Use in basic research

In light of the 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.

References

  1. ↑ GCT1P1 Protocol / Clinical Study: Pilot study of Cisplatin, Etoposide, Bleomycin and Escalating Dose Cyclophosphamide Therapy for Children with High-Risk Malignant Germ Cell Tumors
  2. ↑ 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)

See also

Tumor pages for locations in which teratoma can occur:

Other conditions that may resemble a teratoma:

Technical information

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