Do ovarian teratomas hurt?

Written by Liu Jian Wei
Obstetrics and Gynecology
Updated on September 01, 2024
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Ovarian teratomas do not cause abdominal pain under normal conditions. However, if a patient engages in vigorous activities, it can lead to a torsion of the ovarian teratoma. The torsion of the teratoma can drag the ovary to twist along with it, consequently affecting the blood supply to the adnexa on the affected side, leading to ischemic necrosis of the adnexa, and thus causing a sudden onset of severe lower abdominal pain on one side. In such abnormal situations, the ovarian teratoma can indeed cause lower abdominal pain.

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Written by Li Shun Hua
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How should a teratoma be treated?

In gynecology, a teratoma refers to an ovarian teratoma. The surgical procedure for an ovarian teratoma is tumor excision. Therefore, immediate surgery is required once an ovarian teratoma is diagnosed. During an ultrasound, only the ovarian tumor can be seen, but its nature cannot be determined. Typically, a rapid pathological examination is needed during surgery. If the pathology results still indicate a mature teratoma, it is a benign tumor, and surgical removal is sufficient. Therefore, once discovered, surgical treatment is necessary because if the teratoma grows larger, it can damage the ovaries, potentially causing infertility or reduced ovarian function.

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Does a teratoma require immediate surgery?

Not all teratomas require immediate surgery. If a teratoma is found to be relatively small in size, many people can have it remain stable for a long time without significant changes, therefore periodic monitoring is possible. However, if a teratoma shows a rapid increase in size, or if it is already very large with the potential for torsion, or if there is a possibility of rupture or malignant transformation, or if the teratoma has endocrine activity, then immediate surgery may be necessary.

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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.

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What are the symptoms of teratoma?

Ovarian teratomas can cause abdominal pain and might even result in sudden abdominal enlargement, often accompanied by symptoms like bloating. Women experiencing these symptoms are advised to seek medical attention promptly. Ovarian teratomas are more commonly found in younger women, particularly during their reproductive years. Thus, female patients experiencing these symptoms should promptly undergo an ultrasound at a hospital to check for the presence of teratomas and also have a blood test for tumor markers. If a teratoma is present, it is recommended to undergo surgical treatment as soon as possible due to the risk of malignant transformation.

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Can ovarian teratomas become cancerous?

Most ovarian teratomas are a type of benign tumor on the ovaries, but a few may become malignant. Therefore, if an ultrasound suggests an ovarian teratoma and it is relatively small, around two to three centimeters, without any symptoms, we can temporarily observe it. However, the condition is that we should test for tumor markers, such as checking if there are significant increases in CA-125 or AFP, to see if there's a tendency for malignancy. Another condition is that regular follow-up examinations are essential. If there's a sudden increase in size in a short period or a continuous growth, it is advisable to consider surgical treatment, as early surgical intervention tends to have better outcomes.