Are teratomas mostly benign?

Written by Sun Shan Shan
Obstetrics and Gynecology
Updated on December 31, 2024
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Ovarian teratomas belong to the category of germ cell tumors, which are divided into mature teratomas and immature teratomas. Immature teratomas are malignant and account for 1%-3% of ovarian teratomas, thus they occur relatively less frequently. These are more commonly found in young patients, with an average age of 11-19 years. Mature teratomas, also known as dermoid cysts, are benign and can account for 10%-20% of ovarian tumors and 85%-97% of germ cell tumors, comprising over 95% of ovarian teratomas. These can occur at any age, but are most common between 20-40 years, often unilateral, and may contain components such as fats, hair, and sometimes teeth and bone tissues. Thus, the majority of mature teratomas are benign tumors.

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Why do benign teratomas recur?

Benign teratomas, although not aggressive or metastatic, do not require adjuvant chemotherapy or radiation therapy after curative surgery to fight the tumor. However, many benign teratomas recur after surgery and require further surgical treatment. The cause of benign teratoma recurrence is considered to be due to the persistent presence of oncogenic factors. Therefore, benign tumors can also recur, since the exact cause and pathogenesis of benign teratomas are still unclear clinically. Thus, prevention from an etiological perspective is not possible, and the only option is timely surgical removal upon tumor detection to prevent the benign teratoma from becoming malignant. For patients with benign teratomas, regular follow-up is necessary after curative surgery to monitor any changes in the condition. If signs of recurrence are detected, prompt intervention is necessary to prevent malignancy.

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Can ovarian teratomas be cured?

Ovarian teratoma is a relatively common tumor disease in women, mostly benign in nature, and its development is largely associated with congenital factors. For small ovarian teratomas detected early, regular follow-up examinations are generally sufficient. However, surgery is required when necessary, such as in cases of rapid growth or when endocrine functions are involved, etc. Relying solely on medication to treat teratomas is utterly ineffective, as this type of tumor is a more solid ovarian tumor, and no medication will work.

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What's the matter with ovarian teratoma pain?

The causes of lower abdominal pain in women with ovarian teratomas are complex. Firstly, as the teratoma grows in size, it can, due to gravity, pull on surrounding ligaments, causing pain on one side of the lower abdomen. When the teratoma is particularly large, it can also compress nerves in the pelvis, leading to neuropathic pain. Moreover, teratomas are heterogeneously textured. If they are quite mobile and not adhering to surrounding tissues, sudden changes in body position, or an increase in uterine size during the mid-pregnancy, might shift the position of the teratoma. This can lead to torsion of the stalk, causing local ischemia and hypoxia, and resulting in acute lower abdominal pain.

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What are the symptoms of a teratoma?

Patients with teratomas may have no clinical symptoms whatsoever. Some women only discover ovarian teratomas incidentally during gynecological ultrasound examinations at health check-ups. However, it is important to note that if ovarian teratomas develop complications, they can present a range of clinical symptoms. For example, if an ovarian teratoma undergoes torsion, the patient may experience lower abdominal pain, accompanied by nausea and vomiting. Moreover, if the teratoma has malignant tendencies, it can exhibit a series of clinical manifestations typical of malignant tumors.

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How to treat teratoma?

Teratomas, for women, refer to ovarian teratomas. Once diagnosed, active surgical treatment is necessary. This is because such tumors could be malignant or may undergo torsion, thus requiring prompt treatment. Continued growth can cause destruction of the ovarian tissue, affecting ovarian function. If ovarian torsion occurs, it can lead to the necrosis of the ovary, also impacting its function. Therefore, surgical treatment is needed after diagnosis.