Teratoma


How large must a teratoma be to require surgery?
Ovarian teratomas belong to a type of ovarian germ cell tumor. Ovarian teratomas can be classified into mature teratomas, also known as dermoid cysts, which are a type of benign tumor. There are also immature teratomas, which are malignant tumors commonly found in younger patients, typically between the ages of 11 and 19. If an ovarian teratoma is found to be over three centimeters in diameter, further examinations such as a CA125 test and pelvic CT scan are needed. In the absence of other complications, elective surgical treatment can be planned. However, if the examination reveals high CA125 levels and the pelvic CT confirms the diagnosis, and the cyst is growing rapidly with high blood lipids, timely surgical treatment is necessary, followed by a rapid pathological examination during the surgery.


What should I do if a teratoma recurs?
Teratoma is a type of ovarian cyst, and there is a chance of recurrence after treatment. Clinically, once the recurrence of a teratoma is suspected, it is mostly recommended that the patient undergo surgery again to remove the recurrent teratoma and conduct a postoperative pathological examination to assess whether there is a tendency for the teratoma to become malignant. Further treatment plans are formulated based on the results of the postoperative pathology. After discovering the recurrence of a teratoma, there is no need to panic excessively; it is sufficient to seek medical attention promptly.


Is teratoma related to HPV?
Teratomas are not related to HPV. Teratomas grow on the ovaries, while HPV infections occur in the cervix or vaginal area, so the locations of these two diseases are different. There are benign teratomas and immature teratomas, which must be surgically removed after detection. Most women will be infected with the HPV virus at some point in their lives, and the majority will clear the virus within two years through their immune system, so there is no need to be overly concerned about HPV infections, just regular follow-ups are sufficient.


Can a teratoma be treated with hysteroscopy?
Hysteroscopy is an effective method for the examination and treatment of diseases within the uterine cavity, performed by entering through the vagina and cervix. However, teratomas are tumors commonly located in both ovaries, and since hysteroscopy cannot access the abdominal cavity, it is not possible to perform teratoma surgery with hysteroscopy. If teratomas are found in both ovaries, it is necessary to choose laparoscopy to remove the tumors within the abdominal cavity, rather than using hysteroscopy for treatment.


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.


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.


Can one have sexual intercourse with a teratoma?
Teratoma is a type of ovarian cyst located within the abdominal cavity. Generally, the presence of a teratoma does not affect the patient's ability to have a normal sexual life. However, it is advised not to engage in overly vigorous sexual activity, as intense sexual activity can cause torsion of the ovarian cyst in the abdominal cavity. Once torsion of the ovarian teratoma occurs, it can lead to torsion of both the fallopian tube and the ovary on the affected side. Following torsion, the twisted fallopian tube and ovary lack blood supply, which can further lead to ischemia and necrosis. In such cases, it becomes necessary to surgically remove the affected fallopian tube and ovary.


Is ovarian teratoma a major surgery?
Generally, ovarian teratomas are considered major surgeries and are closely related to the nature of the teratomas. These are common major gynecological surgeries. It is recommended to visit the obstetrics and gynecology department for comprehensive examinations and a full-body assessment. Additionally, procedures such as biopsy are needed to determine the nature of the tumor, after which an appropriate treatment plan can be chosen. Options generally include open surgery or laparoscopic surgery, both of which are relatively major procedures.


Teratoma Benign and Malignant Differences
Teratoma refers to a common type of germ cell tumor, which can be classified into mature teratomas and immature teratomas. Mature teratomas are benign tumors, accounting for 10%-20% of ovarian tumors. They can occur at any age but are more common between the ages of 20 and 40. Most are unilateral, of moderate size, and usually have a single compartment filled with sebum and hair; sometimes teeth and bone can also be found. Immature teratomas, on the other hand, are malignant tumors, making up 1%-3% of ovarian teratomas. These are more frequent in younger patients, with an average age of 11 to 19 years. The ovaries are predominantly solid but may include cystic areas, primarily consisting of primitive neural tissue. The malignancy level of the ovary depends on the proportion of immature tissue, the degree of differentiation, and the content of neuroepithelial tissue.


Can a teratoma be detected by ultrasound?
Teratomas are a common type of solid tumor in the ovaries, and the vast majority of ovarian teratomas are benign. The most common method to examine teratomas in women is to perform an ultrasound. Generally, an abdominal ultrasound can be done 3-7 days after the menstrual cycle has ended to observe the ultrasonic echo of both ovaries. Normally, both ovaries are uniform in size and echo. If the ultrasound suggests the presence of a substantive mass on the ovary, which has a strong echo, or indicates the presence of fat or bone echoes, then this condition is highly suspected to be a teratoma. For ovarian teratomas, if the size is relatively small and there are no clinical symptoms, temporary observation is possible. However, if it is larger than five centimeters, laparoscopic removal is generally recommended.