Clinical manifestations of teratoma

Teratomas have different clinical symptoms and manifestations due to their different locations, multiple complications, and obvious malignant tendencies. Teratomas are tumors derived from germ cells with multidirectional differentiation potentials, often containing a variety of tissue components from the three germ layers with disordered arrangement structures. Let's take a look at the various clinical symptoms and manifestations of teratomas.

Teratomas are divided into three categories according to their maturity:

Cystic mature teratoma: also known as dermoid cyst, it has an intact capsule and the cavity may contain hair, sebum, and cartilage components. About 9% to 15% of them become malignant, among which squamous cell carcinoma is the most common and adenocarcinoma is rare.

Solid teratoma: It is a solid mass with cysts of varying sizes on the cut surface, with hemorrhage and necrosis inside. Under the microscope, all germ layer tissue components can be seen, with the endoderm being the majority. The maturity of this disease is between benign and malignant, which is called intermediate teratoma.

Immature teratoma: The tumor contains undifferentiated immature tissue components, also known as malignant teratoma. It grows rapidly, often infiltrates adjacent tissues and causes severe symptoms, metastasizes through blood and lymph nodes, and is usually more common in adenocarcinoma.

What are the symptoms of teratoma?

1. Painless mass: This is the most common symptom of teratoma. Most of them are round cystic with clear boundaries and uneven hardness. Even bony nodules can be palpated. Exophytic tumors are common in midline areas such as the sacrococcygeal, occipital, forehead, and nose. Sacrococcygeal teratoma can be divided into three clinical types according to its location: overt, latent, and mixed.

2. Compression and cavity obstruction symptoms: Mediastinal teratomas can often compress the respiratory tract and cause choking, dyspnea, and distended neck veins; retroperitoneal teratomas often cause abdominal pain and can cause intestinal obstruction. Pelvic and sacrococcygeal occult teratomas are often diagnosed due to constipation, difficulty defecating, and urinary retention.

3 Acute symptoms of abnormal tumor changes: Ovarian and testicular teratomas may cause ovarian or testicular torsion and necrosis, manifested by severe pain and corresponding local symptoms; when secondary infection and intracystic bleeding occur in teratomas, the tumor may often increase rapidly, with obvious local tenderness, and accompanied by systemic infection or blood loss symptoms such as fever, anemia, and shock; tumors in the retroperitoneum, ovaries, pelvis, sacrum, and other parts of the body may also suddenly rupture and cause massive bleeding, hemoperitoneum, shock, and other dangerous manifestations.

4. Symptoms of tumor malignancy: When malignant teratomas and benign teratomas become malignant, they often show rapid tumor growth and loss of original elasticity. For exophytic tumors, superficial veins may be dilated and congested, and local skin may be infiltrated with increased skin temperature. Lymph node enlargement and lung and bone metastasis may occur through lymphatic and blood circulation, and systemic symptoms such as weight loss, anemia, and tumor fever may also occur.