How to Determine if a Teratoma is Benign

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on December 25, 2024
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Teratomas in women are classified into benign and malignant categories. Benign teratomas typically have a complete capsule and grow very slowly. Some women find that the size of the teratoma does not change significantly during follow-up exams. Malignant teratomas, however, grow quickly and can present severe clinical symptoms, such as abdominal pain, bloating, and pelvic masses, with some women also experiencing fluid accumulation in the abdominal cavity. Furthermore, blood tests for gynecological tumor markers can also be used for differentiation. For example, in malignant tumors, markers such as CA-125, CA-199, and alpha-fetoprotein are elevated to varying degrees, particularly alpha-fetoprotein. During a CT scan, malignant teratomas may show unclear borders, potentially indicating invasion into the surrounding tissues. Additionally, after surgical removal of the tumor, pathological histological examination can be conducted for further differentiation. For instance, malignant teratomas tend to have a higher proportion of immature components.

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Written by Zhao Xiao Dong
Obstetrics and Gynecology
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Will the teratoma recur after the ovary is removed?

For teratomas, ovarian tumor excision surgery is generally chosen. If the teratoma is too large, and the remaining ovarian tissue is insufficient, there is no need to preserve the ovary, or if the teratoma has severe torsion causing ovarian tissue necrosis, an oophorectomy is necessary. After the oophorectomy, recurrence on the same side is generally not observed, but there is sometimes a possibility of recurrence on the opposite side, though the likelihood of recurrence is very low. Generally, if one ovary is removed due to a teratoma, the recurrence rate on the opposite side is usually less than 10%. Treatment of teratomas is generally surgical, and if not treated timely, complications such as torsion may occur.

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Written by Sun Shan Shan
Obstetrics and Gynecology
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Are teratomas mostly benign?

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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Written by Li Shun Hua
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Will a teratoma regrow if it is removed?

After surgery for ovarian teratoma, whether it can regrow is uncertain, because ovarian tissue can potentially develop such tumors. Ovarian teratomas can be benign or malignant. The recurrence rate of benign teratomas is very low after surgery, but there is still a possibility of regrowth. However, for malignant teratomas, also known as immature teratomas, surgery involves removing the affected ovary. The opposite ovary can be preserved if it is normal, depending on the patient's age, but regular follow-ups are necessary. If the patient is older, an extensive surgery for teratoma, which includes the removal of both the uterus and ovaries, might be required.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Can women with ovarian teratomas have children?

Ovarian teratomas, if discovered after pregnancy, do not significantly impact the child; however, it's crucial to confirm that the ovarian teratoma is benign. If detected during pregnancy, close observation is possible, and sudden lower abdominal pain may indicate ovarian torsion, which requires timely surgical intervention. If there are no symptoms, surgery can wait until after the child is born. If an ovarian teratoma is discovered before pregnancy, it is advisable to undergo surgery before becoming pregnant because ovarian teratomas can sometimes be malignant, and torsion may occur during pregnancy, which could affect the child.

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How is a teratoma diagnosed?

Teratomas are mostly diagnosed through symptoms, such as abdominal pain or bloating, and are identified with an ultrasound examination. Generally, these two tests are used. Additionally, blood tests may be conducted, but there are no very specific tumor markers that will be revealed. The primary means of diagnosis still rely on ultrasound and gynecological palpation. If a woman of childbearing age experiences unexplained abdominal pain, feels bloated, or notices occasional increases in abdomen size, it is recommended to undergo a gynecological ultrasound examination at a hospital.