The incidence rate of teratomas is about 1.2 to 14.2 cases per 100,000 population per year, with the majority being ovarian teratomas. Teratomas are more common in women of reproductive age. A type of the same, mature cystic teratomas, comprise 10% to 20% of all ovarian neoplasms, and they are one of the most common germ cell tumours.

In this article, we will explore all the information you require about teratomas, their types, causes, risk factors, and treatment options. 

What is a Teratoma?

A teratoma is a germ-cell tumour that arises from germinal layers in the body. It stands out from conventional tumours as it has a distinct composition and can contain multiple types of tissues, such as hair, teeth, bone, etc. 

Most teratomas are benign, while some can become malignant and metastasise to a different location in the body. They usually occur in the ovary, testis, and tailbone region. 

Causes  of Teratoma

To date, the exact cause of teratomas is unknown, and it has an idiopathic cause. However, several factors are known to accelerate the process of tumour formation. The suspected causes of teratoma include:

• Genetic conditions affecting the central nervous system, genitourinary tract, and the spine
• Changes in embryonic stem cells during development

While a foetus is in its developmental stage, some of the cells which do not differentiate, retain the ability to turn into other types of cells. These types of cells are then known as pluripotent cells.

Risk Factors of Teratoma

Some of the risk factors are known, which help in turning ovarian teratomas into malignant tumours. These include:

• Older age
• Larger tumour size
• Elevated levels of tumour marker CA-125
• Post-menopausal women

There are also a number of risk factors which do not cause the tumour directly but help in accelerating the tumour formation. These include:

• Low birth weight 
• Cryptorchidism
• Hypospadias
• Maternal bleeding 
• Increased maternal age
• Retained placenta
• Jaundice

What are the Various Types of Teratomas?

Teratomas are classified based on various criteria, like nature, location, etc.

• Based on the Nature of a Teratoma 
  • Mature Teratoma: These teratomas are usually benign in nature and are non-cancerous.
  •  Immature Teratoma: These are the malignant and cancerous types of teratomas. They are more commonly seen in children.

• Based on the Location of a Teratoma
  • Ovarian Teratoma: The most common type seen in females. These rarely turn cancerous.
  • Testicular Teratoma: The most common type seen in males. In young aged males, these are non-cancerous. However, in older males, they have a 50% chance of becoming malignant.
  • Sacrococcygeal Teratoma: They are commonly seen in children. However, these have a very rare chance of incidence, about 1 in 40000 live births. The location is near the tailbone, and the female gender is predominantly affected.

Apart from these, a rare type of teratoma is the Fetiform teratoma, with an incidence of 1 in 50000 people. It is a type of dermoid cyst that closely resembles a malformed fetus. However, due to the absence of a placenta and an amniotic sac, this fetus can never develop to full term. Usually, it is diagnosed within the first 18 months of life.

What are the Various Symptoms of a Teratoma?

It is difficult to track the presence of a teratoma in the body until it becomes a grave concern. An individual tends to be completely healthy and asymptomatic in the early stages. Some of the generalised symptoms of teratoma include:

• Pain
• Bleeding
• Swelling
• Sudden unexplained weight loss
• Elevated levels of beta-hCG (beta-human Chorionic Gonadotropin)
• Elevated levels of alpha-fetoprotein ( a tumour marker)

A few symptoms which are specific for a particular type of teratoma include:

• Ovarian Teratoma
  • Abdominal pain
  • Pelvic pain
  • NMDA Encephalitis (Rare)

• Testicular Teratoma
  • Lump in testicle
  • Swelling of one or both testicles

• Sacrococcygeal Teratoma
  • Coccydynia (Pain in the tailbone)
  • Visible mass in the tailbone area
  • Abdominal Pain
  • Constipation
  • Dysuria (Pain during urination)
  • Pubic swelling
  • Weakness in lower limbs

How to Diagnose a Teratoma?

If a teratoma is suspected in the body, a physician would do a general physical examination of your body. If there is no visible anomaly, they would proceed to the advanced tests, which include:

• Imaging tests:
  • X-rays
  • Computed Tomography Scan (CT Scan)
  • MRI
  • Ultrasonography

• Blood tests: These are performed to ensure that the tumour markers and other indices are within the normal range for each age and gender.
• Biopsy: One of the most accurate tests to confirm the presence of a teratoma. It can also help us to identify whether the teratoma is benign or malignant.

What are the Treatment Options Available?

The most common option is to undergo surgery. However, if the surgery is in a vital area of the body, such that it poses a threat to the life of the person, then the doctor may choose other options like:

• Chemotherapy
• Radiotherapy
• Chemoradiation (a mix of the two above)

Currently, no preventive measures are available. However, regular checkups and a healthy lifestyle may help reduce the risk to some extent.

FAQs about Teratomas

1. What are the odds of having a teratoma develop on your face?

Though it is rare for a teratoma to develop on a face, the odds are not nil. Teratomas may sometimes develop on the face and neck, with a probability of 6 in 100 cases.

2. What makes the teratoma develop teeth and hair?

Teratomas are a type of germ cell tumour (GCT). These germ cells are responsible for the development of all the structures of the human body, from the skin to the tiniest blood vessels. Hence, teratomas can also develop different types of tissues like hair, bone, teeth, muscles, and nerves.

3. Which teratoma is the most common?

The mature cystic teratoma, which is benign in nature, has the highest rate of incidence among all cases of teratoma.

4. Can a teratoma have a heartbeat?

Yes. Since the teratoma is a germ cell tumour, it can also produce cardiac muscles, which can theoretically have a heartbeat. However, practically speaking, the chances are very scarce.

5. What is the average size of a teratoma?

Studies reveal that the mean size of a teratoma with torsion is 6.5 ± 2.6 cm, and for teratomas that can rupture, the mean size is about 5.3 ± 2.6 cm.

Conclusion

Teratomas are a topic of major complications. However, with the advancement in technology, one can surely hope for betterment in the future. With DocTutorials, you can access a plethora of video lectures, notes, Qbanks, and other resources to help you ace your NEET PG exam. Log in and enjoy the demo videos for free.