Can teratoma be treated without surgery?

Teratoma is a benign gynecological tumor. After a teratoma is found, it is necessary to go to the hospital for treatment in time. If a benign tumor is not treated, it is easy to deteriorate into a malignant tumor. The best way at present is to treat it through surgery. For non-surgical methods, the use of drugs for treatment, experts say, the effect is not good. Let's learn about ovarian mature teratoma and its treatment.

Mature cystic teratomas mostly occur in women of childbearing age around 30 years old. The clinical symptoms are non-specific, mainly manifested as pelvic masses. 25% of patients are discovered accidentally, and 10% of patients will experience acute abdominal pain due to tumor rupture, torsion or bleeding. Ultrasound examination has a high diagnostic rate, and unilateral ovarian cystic solid mass can usually be seen. The typical sonogram has dough sign, wall nodule sign, chaotic structure sign, lipid layering sign or waterfall sign. Serological examination may show mild elevation of CA199, AFP, etc. Complications include torsion, rupture and infection. Cyst torsion can cause necrosis, perforation and intraperitoneal hemorrhage, and cyst rupture can cause chemical peritonitis. Sebum overflowing into the abdominal cavity can form peritoneal oil granulomas. Mature teratomas containing glial components can form implants in the peritoneum after rupture, which is called peritoneal pseudogliomatosis. Immature teratomas grow rapidly and can penetrate the capsule in the early stage and spread directly to the pelvic and abdominal cavity for implantation. Lymph node metastasis and extraperitoneal metastasis may occur subsequently, and in the late stage, hematogenous metastasis to the lungs, liver and other organs may occur.

Patients with ovarian teratoma should choose surgical treatment. The scope of surgery can include resection of the affected side adnex, removal of the affected side teratoma and (or) biopsy of the contralateral ovary. The surgical method can be laparoscopic or laparotomy. The benign or malignant nature of the teratoma can be preliminarily determined based on the intraoperative findings. If it is suspected to be a malignant tumor, it should be sent for frozen pathology examination as soon as possible. Malignant teratoma should also undergo complete staging surgery as much as possible. During the operation, the pelvic cavity is fully explored, the greater omentum and peritoneum are removed, and lymph node biopsies are performed to understand the scope of tumor infiltration and the degree of involvement of various organs and tissues. For young patients with malignant teratoma who have fertility requirements, surgery to preserve fertility can be considered. The chemotherapy regimen currently recommended by WHO is the BEP regimen.