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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| {{Infobox_Disease | | | {{Teratoma}} |
| Name = {{PAGENAME}} |
| | {{CMG}} |
| Image = Teratoma congenital.jpg|
| | {{MJM}} |
| 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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| ICDO = 9080 |
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| MeshID = D013724 |
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| }} | |
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| {{Editor Join}}
| | ==[[Teratoma overview|Overview]]== |
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| ==Overview== | | ==[[Teratoma historical perspective|Historical Perspective]]== |
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| A '''teratoma''' is a type of [[neoplasia|neoplasm]] (specifically, a [[tumor]]). The word teratoma comes from Greek and means roughly "monstrous tumor". Definitive diagnosis of a teratoma is based on its [[histology]]: a teratoma is a tumor with [[biological tissue|tissue]] or [[organ (anatomy)|organ]] components resembling normal derivatives of all three [[germ layer]]s. Rarely, not all three germ layers are identifiable. The tissues of a teratoma, although normal in themselves, may be quite different from surrounding tissues, and may be highly inappropriate, even grotesque (hence the ''monstrous''): teratomas have been reported to contain [[hair]], [[teeth]], [[bone]] and very rarely more complex organs such as [[eye]]ball, [[torso]], and [[hand]]. Usually, however, a teratoma will contain no organs but rather one or more tissues normally found in organs such as the [[brain]], [[thyroid]], [[liver]], and [[lung]].
| | ==[[Teratoma classification|Classification]]== |
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| Teratomas are thought to be present at birth, but often they are not diagnosed until much later in life.
| | ==[[Teratoma pathophysiology|Pathophysiology]]== |
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| ==Natural history== | | ==[[Teratoma causes|Causes]]== |
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| {{main|Germ cell tumor}}
| | ==[[Teratoma differential diagnosis|Differentiating Teratoma from other Diseases]]== |
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| Teratomas belong to a class of tumors known as [[nonseminoma]]tous [[germ cell tumor]] (NSGCT). All tumors of this class are the result of abnormal development of [[pluripotent]] cells: [[germ cell]]s and [[embryo|embryonal cells]]. Teratomas of embryonal origin are [[congenital disorder|congenital]]; teratomas of germ cell origin may or may not be congenital (this is not known). The kind of pluripotent cell appears to be unimportant, apart from constraining the location of the teratoma in the body.
| | ==[[Teratoma epidemiology and demographics|Epidemiology and Demographics]]== |
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| ===Location and incidence=== | | ==[[Teratoma risk factors|Risk Factors]]== |
| [[Image:teratoma_back.jpg|thumb|left|Mature cystic teratoma of ovary (benign) Courtesy of Ed Uthman, MD]] | |
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| Teratomas derived from germ cells occur in the [[testes]] in males and [[ovary|ovaries]] in females. Teratomas derived from embryonal cells usually occur on the body midline: in the brain, elsewhere inside the [[skull]], in the nose, in the tongue, under the tongue, and in the [[neck]] (cervical teratoma), [[mediastinum]], [[retroperitoneum]], and attached to the [[coccyx]]. However, teratomas may also occur elsewhere: very rarely in solid organs (most notably the heart and liver) and hollow organs (such as the stomach and bladder), and more commonly on the [[cranial sutures|skull sutures]]. Embryonal teratomas most commonly occur in the sacrococcygeal region: [[sacrococcygeal teratoma]] is the single most common tumor found in [[Infant|newborn babies]].
| | ==[[Teratoma screening|Screening]]== |
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| Of teratomas on the skull sutures, approximately 50% are found in or adjacent to the [[orbit (anatomy)|orbit]]<ref>[http://www.emedicine.com/oph/topic620.htm Emedicine article on orbital dermoid cyst]</ref>. '''Limbal dermoid''' is a '''choristoma''', not a teratoma.
| | ==[[Teratoma natural history|Natural History, Complications and Prognosis]]== |
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| Teratoma qualifies as a [[rare disease]], but is not extremely rare. Sacrococcygeal teratoma alone is diagnosed at birth in 1 out of 40,000 babies. Given the current [[world population]] [[birth rate]], this equals 5 per day or 1800 per year. Add to that number sacrococcygeal teratomas diagnosed later in life, and teratomas in other locations, and the [[Incidence (epidemiology)|incidence]] approaches 10,000 new diagnoses of teratoma per year.
| | ==Diagnosis== |
| | | [[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]] |
| ===Hypotheses of origin=== | |
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| Concerning the origin of teratomas, there exist numerous hypotheses.<ref name="Gonzalez-Crussi1982">Gonzalez-Crussi, F. (1982) Extragonadal Teratomas. Atlas of Tumor Pathology, Second Series, Fascicle 18. Armed Forces Institute of Pathology, Washington D.C.</ref> These hypotheses are not to be confused with the unrelated hypothesis that [[fetus in fetu]] (see below) is not a teratoma at all but rather a [[parasitic twin]].
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| === Dermoid cyst ===
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| A [[dermoid cyst]] is a mature teratoma containing hair (sometimes very abundant) and other structures characteristic of normal skin and other tissues derived from the ectoderm. The term is most often applied to teratoma on the skull sutures and in the ovaries of females.
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| === Fetus in fetu and fetiform teratoma===
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| '''Fetus in fetu''' and '''fetiform teratoma''' are rare forms of mature teratoma that include one or more components resembling a malformed fetus. Both forms may contain or appear to contain complete organ systems, even major body parts such as torso or limbs. Fetus in fetu differs from fetiform teratoma in having an apparent [[vertebral column|spine]] and bilateral symmetry.<ref name="Gonzalez-Crussi1982"/>
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| Most authorities agree that fetiform teratomas are highly developed mature teratomas; the natural history of fetus in fetu, however, is controversial.<ref name="Gonzalez-Crussi1982"/> There also may be a cultural difference, with fetiform teratoma being reported more often in ovarian teratomas (by gynecologists) and fetus in fetu being reported more often in retroperitoneal teratomas (by general surgeons). [[Fetus in fetu]] has often been interpreted as a [[fetus]] growing within its [[twin]]. As such, this interpretation assumes a special complication of [[twin]]ning, one of several grouped under the term [[parasitic twin]]. In this regard, it is noteworthy that in many cases the fetus in fetu is reported to occupy a fluid-filled cyst within a mature teratoma.<ref>Saito K, Katsumata Y, Hirabuki T, Kato K, Yamanaka M. Fetus-in-fetu: Parasite or Neoplasm? A Study of Two Cases. Fetal Diagn Ther. 2007 Jun 5;22(5):383-388</ref><ref>Kajbafzadeh AM, Baharnoori M. Fetus in fetu. Can J Urol. 2006 Oct;13(5):3277-8.</ref><ref>Chua JH, Chui CH, Sai Prasad TR, Jabcobsen AS, Meenakshi A, Hwang WS. Fetus-in-fetu in the pelvis: report of a case and literature review. Ann Acad Med Singapore. 2005 Nov;34(10):646-9. [http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16382253 PubMed abstract and free full text PDF]</ref> Cysts within mature teratoma have also been reported to contain a rudimentary beating heart.<ref>{{cite journal
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| |author=Kazez A, Ozercan IH, Erol FS, Faik Ozveren M, Parmaksiz E
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| |title=Sacrococcygeal heart: a very rare differentiation in teratoma.
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| |journal=European journal of pediatric surgery (Zeitschrift für Kinderchirurgie)
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| |volume=12
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| |issue=4 | |
| |pages=278-80
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| |year=2002
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| |pmid=12369008
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| |doi=10.1055/s-2002-34483
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| |issn=
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| }}{{PMID|12369008}}</ref>
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| Regardless of whether fetus in fetu and fetiform teratoma are one entity or two, they are distinct from and not to be confused with [[ectopic pregnancy]].
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| === Struma ovarii ===
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| A '''struma ovarii''' (literally: [[goitre]] of the ovary) is a rare form of mature teratoma that contains mostly [[thyroid]] tissue. Despite its name, struma ovarii is not restricted to the ovary. Only 5% of struma ovarii are malignant.
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| ==Pathology classification of individual teratomas==
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| Teratomas commonly are classified using the Gonzalez-Crussi<ref name="Gonzalez-Crussi1982"/> grading system: 0 or mature ([[benign]]); 1 or immature, probably benign; 2 or immature, possibly [[malignant]] ([[cancer]]ous); and 3 or frankly malignant. See also [[cancer staging]]. Teratomas are also classified by their content: a solid teratoma contains only tissues (perhaps including more complex structures); a cystic teratoma contain only pockets of fluid or semi-fluid such as [[cerebrospinal fluid]], [[sebum]], or fat; a mixed teratoma contains both solid and cystic parts. Cystic teratomas usually are grade 0 and, conversely, grade 0 teratomas usually are cystic.
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| Grade 0, 1 and 2 pure teratomas have the potential to become malignant (grade 3), and malignant pure teratomas have the potential to [[metastasize]]. These rare forms of '''teratoma with malignant transformation''' may contain elements of somatic (non germ cell) malignancy such as [[leukemia]], [[carcinoma]] or [[sarcoma]].<ref name="pmid17080330">{{cite journal
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| |author=Harms D, Zahn S, Göbel U, Schneider DT | |
| |title=Pathology and molecular biology of teratomas in childhood and adolescence.
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| |journal=Klinische Pädiatrie
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| |volume=218
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| |issue=6
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| |pages=296-302
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| |year=2006
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| |pmid=17080330
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| |doi=10.1055/s-2006-942271
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| }}</ref>
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| A teratoma may contain elements of other germ cell tumors, in which case it is not a pure teratoma but rather is a '''mixed''' [[germ cell tumor]] and is malignant. In infants and young children, these elements usually are [[endodermal sinus tumor]], followed by [[choriocarcinoma]]. Finally, a teratoma can be pure and not malignant yet highly aggressive: this is exemplified by '''growing teratoma syndrome''', in which chemotherapy eliminates the malignant elements of a mixed tumor, leaving pure teratoma which paradoxically begins to grow very rapidly.
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| === "Benign" teratoma may prove to be malignant ===
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| A "benign" grade 0 (mature) teratoma nonetheless has a non-zero risk of malignancy. Recurrence with malignant [[endodermal sinus tumor]] has been reported in cases of formerly benign mature teratoma,<ref name="pmid9781660">{{cite journal
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| | author = Ohno Y, Kanematsu T
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| | title = An endodermal sinus tumor arising from a mature cystic teratoma in the retroperitoneum in a child: is a mature teratoma a premalignant condition?
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| | journal = Hum. Pathol.
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| | volume = 29
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| | issue = 10
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| | pages = 1167-9
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| | year = 1998
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| | pmid = 9781660
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| | doi =
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| | issn =
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| }}</ref> even in fetiform teratoma and fetus in fetu.<ref name="pmid17561476">{{cite journal
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| | author = Chen YH, Chang CH, Chen KC, Diau GY, Loh IW, Chu CC
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| | title = Malignant transformation of a well-organized sacrococcygeal fetiform teratoma in a newborn male.
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| | journal = J. Formos. Med. Assoc.
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| | volume = 106
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| | issue = 5
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| | pages = 400-2
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| | year = 2007
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| | pmid = 17561476
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| | doi =
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| }} (publisher offers free full text PDF to registered users)</ref><ref name="pmid9349774">{{cite journal
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| | author = Hopkins KL, Dickson PK, Ball TI, Ricketts RR, O'Shea PA, Abramowsky CR
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| | title = Fetus-in-fetu with malignant recurrence.
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| | journal = J. Pediatr. Surg.
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| | volume = 32
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| | issue = 10
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| | pages = 1476-9
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| | year = 1997
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| | pmid = 9349774
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| | doi =
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| }}</ref> A grade 1 immature teratoma that appears to be benign (e.g., because AFP is not elevated) has a much higher risk of malignancy, and requires '''adequate follow-up'''.<ref name="pmid15895292">{{cite journal
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| | author = Muscatello L, Giudice M, Feltri M
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| | title = Malignant cervical teratoma: report of a case in a newborn.
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| | journal = European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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| | volume = 262
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| | issue = 11
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| | pages = 899-904
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| | year = 2005
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| | pmid = 15895292
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| | doi = 10.1007/s00405-005-0917-2
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| | issn =
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| }}</ref><ref name="pmid15928937">{{cite journal
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| | author = Ukiyama E, Endo M, Yoshida F, Tezuka T, Kudo K, Sato S, Akatsuka S, Hata J
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| | title = Recurrent yolk sac tumor following resection of a neonatal immature gastric teratoma.
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| | journal = Pediatr. Surg. Int.
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| | volume = 21
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| | issue = 7
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| | pages = 585-8
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| | year = 2005
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| | pmid = 15928937
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| | doi = 10.1007/s00383-005-1404-y
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| | issn =
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| }}</ref><ref name="pmid7508500">{{cite journal
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| | author = Bilik R, Shandling B, Pope M, Thorner P, Weitzman S, Ein SH
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| | title = Malignant benign neonatal sacrococcygeal teratoma.
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| | journal = J. Pediatr. Surg.
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| | volume = 28
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| | issue = 9
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| | pages = 1158–60
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| | year = 1993
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| | pmid = 7508500
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| | doi =
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| }}</ref><ref name="pmid7692755">{{cite journal
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| | author = Hawkins E, Issacs H, Cushing B, Rogers P
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| | title = Occult malignancy in neonatal sacrococcygeal teratomas. A report from a Combined Pediatric Oncology Group and Children's Cancer Group study.
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| | journal = The American journal of pediatric hematology/oncology
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| | volume = 15
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| | issue = 4 | |
| | pages = 406–9
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| | year = 1993
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| | pmid = 7692755
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| }}</ref>
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| === Teratoma with malignant transformation===
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| A '''teratoma with malignant transformation''' or '''TMT''' is a very rare form of teratoma that may contain elements of somatic (non germ cell) malignant tumors such as [[leukemia]], [[carcinoma]] or [[sarcoma]].<ref name="pmid17080330">{{cite journal
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| |author=Harms D, Zahn S, Göbel U, Schneider DT
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| |title=Pathology and molecular biology of teratomas in childhood and adolescence.
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| |journal=Klinische Pädiatrie
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| |volume=218
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| |issue=6
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| |pages=296-302
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| |year=2006
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| |pmid=17080330
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| |doi=10.1055/s-2006-942271
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| }}</ref> Of 641 children with pure teratoma, 9 developed TMT<ref>{{cite journal
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| | author = Biskup W, Calaminus G, Schneider DT, Leuschner I, Göbel U
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| | title = Teratoma with malignant transformation: experiences of the cooperative GPOH protocols MAKEI 83/86/89/96.
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| | journal = Klinische Pädiatrie | |
| | volume = 218
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| | issue = 6
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| | pages = 303-8
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| | year = 2006
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| | pmid = 17080331
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| | doi = 10.1055/s-2006-942272
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| | issn =
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| }}</ref>: 5 [[carcinoma]], 2 [[glioma]], and 2 embryonal (here, these last are classified among germ cell tumors).
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| === Extraspinal ependymoma ===
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| [[ependymoma|Extraspinal ependymoma]], usually considered to be a [[glioma]] (a type of non-germ cell tumor), may be an unusual form of mature teratoma.<ref>Aktuğ T, Hakgüder G, Sarioğlu S, Akgür FM, Olguner M, Pabuçcuoğlu U. (2000) Sacrococcygeal extraspinal ependymomas: the role of coccygectomy. J Pediatr Surg. 35(3):515-518. [http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=10726703&dopt=AbstractPlus PubMed]</ref>
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| ==Initial diagnosis==
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| Teratomas are thought to be present since birth, or even before birth, and therefore can be considered [[congenital]] tumors. However, many teratomas are not diagnosed until much later in childhood or in adulthood. Large tumors are more likely to be diagnosed early on. Sacrococcygeal and cervical teratomas are often detected by prenatal [[ultrasound]]. Additional diagnostic methods may include prenatal [[magnetic resonance imaging|MRI]]. In rare circumstances, the tumor is so large that the [[fetus]] may be damaged or die. In the case of large sacrococcygeal teratomas, a significant portion of the fetus' [[blood flow]] is redirected toward the teratoma (a phenomenon called [[steal syndrome]]), causing [[Congestive heart failure|heart failure]], or [[hydrops fetalis|hydrops]], of the fetus. In certain cases, [[fetal surgery]] may be indicated.
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| Beyond the newborn period, symptoms of a teratoma depend on its location and organ of origin. [[Ovarian]] teratomas often present with abdominal or [[Chronic pelvic pain|pelvic pain]], caused by torsion of the [[ovary]] or irritation of its ligaments. Testicular teratomas present as a palpable mass in the [[testis]]; [[mediastinum|mediastinal]] teratomas often cause compression of the lungs or the airways and may present with [[chest pain]] and/or respiratory symptoms.
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| Some teratomas contain [[yolk sac]] elements, which secrete [[alpha-fetoprotein]] (AFP). Detection of AFP may help to confirm the diagnosis and is often used as a marker for recurrence or treatment efficacy, but is rarely the method of initial diagnosis. (Maternal serum [[alpha-fetoprotein]], or MSAFP, is a useful [[Screening (medicine)|screening test]] for other fetal conditions, including [[Down syndrome]], [[spina bifida]] and abdominal wall defects such as [[gastroschisis]]).
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Germ-cell-tumor-001.jpg|CT shows [[Mediastinal germ cell tumor | Mediastinal Teratoma]]
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| </gallery>
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| </div>
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| ==Time of presentation==
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| Teratomas of germ cell origin usually are found (i.e., ''present'') in adult men and women, but they may also be found in children and infants. Teratomas of embryonal origin are most often found in babies at birth, in young children, and, since the advent of [[Medical ultrasonography|ultrasound imaging]], in fetuses.
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| The most commonly diagnosed fetal teratomas are [[sacrococcygeal teratoma]] (Altman types I, II, and III) and cervical (neck) teratoma. Because these teratomas project from the fetal body into the surrounding [[Amniotic sac|amniotic fluid]], they can be seen during routine prenatal ultrasound exams. Teratomas within the fetal body are less easily seen with ultrasound; for these, MRI of the pregnant uterus is more informative.<ref>Diagnosis and characterization of fetal sacrococcygeal teratoma with prenatal MRI.
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| Danzer E, Hubbard AM, Hedrick HL, Johnson MP, Wilson RD, Howell LJ, Flake AW, Adzick NS.
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| AJR Am J Roentgenol. 2006 Oct;187(4):W350-6.
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| PMID: 16985105
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| [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16985105&query_hl=1&itool=pubmed_docsum PubMed]</ref><ref>Pediatric presacral masses. | |
| Kocaoglu M, Frush DP.
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| Radiographics. 2006 May-Jun;26(3):833-57. Review.
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| PMID: 16702458
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| [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16702458&query_hl=1&itool=pubmed_docsum PubMed Free Text]</ref> | |
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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
| |
| | 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
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| | issue = 2
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| | pages = 353-8
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| | year = 1999
| |
| | pmid = 10454682
| |
| | doi =
| |
| | issn =
| |
| }}</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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| ==External links==
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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}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |
| | [[Category:Up-To-Date]] |
| | [[Category:Oncology]] |
| | [[Category:Medicine]] |