What is the chance of recurrence of ovarian teratoma after surgery?

Ovarian teratomas are common in women of childbearing age. They account for about 15% of the total number of primary ovarian tumors, of which 95%-98% are benign mature teratomas and only 2%-5% are malignant teratomas. 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. So, what is the chance of recurrence of ovarian teratomas after surgery?

The recurrence rate of mature cystic teratoma is about 2%, and the recurrence interval is more than 10 years, which is more common in patients with bilateral lesions. The malignant transformation rate of mature cystic teratoma is 2%-3%, and malignant transformation is prone to occur near the head segment, with squamous cell carcinoma being the most common. Patients with squamous cell carcinoma have a poor prognosis, with a mortality rate of 75%-86%. The recurrence rate of immature teratoma is above 50%, but recurrent immature teratoma has the characteristic of transformation from immaturity to maturity. Over time, the malignancy gradually decreases.

Disease prevention

The cause of teratoma is currently unknown and there is no effective way to prevent it. The key is to do regular pelvic examinations to achieve early diagnosis and early treatment.

Clinical manifestations

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.