The difference between teratoma and ovarian cysts

Written by Li Lin

Obstetrics and Gynecology

Updated on May 14, 2025

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Teratomas are commonly found in both ovaries and can be distinguished from ovarian cysts by their appearance. Ovarian cysts contain a fluid similar to water, whereas teratomas typically contain sebaceous fluid and may also include tissues such as hair, bones, or teeth. Under a microscope, ovarian cysts show epithelial-like changes, while teratomas exhibit changes typical of germ cells. Teratomas and ovarian cysts can also be easily differentiated using color ultrasound examinations.

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Does teratoma require blood tests?

If a patient with a teratoma needs to undergo a blood test, the blood test may include routine blood work and blood biochemistry, as well as tumor marker tests such as CA125 and alpha-fetoprotein (AFP) to check for any abnormal increases. If surgery is required for the patient, there might be additional blood tests conducted, including lipid profile, thyroid function tests, and infection and immunity tests. All these require blood draws for the examination.

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Is it easy to get pregnant with a teratoma?

First, what is a teratoma? Teratoma is a common ovarian tumor in gynecology, with a very high incidence rate. It is generally benign and the occurrence of teratomas is related to congenital genetic factors. Generally, if a teratoma is found, the first step is to check the size of the teratoma. If it is smaller than five centimeters, tumor series tests are normal, and there is no other discomfort, observation can be initiated. If the teratoma is relatively large, larger than five centimeters, surgical intervention is required. Teratomas themselves are not related to pregnancy, but because teratomas can lead to ovarian cyst torsion, after torsion occurs, one side of the adnexa may need to be removed, which could reduce fertility.

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What to do about ovarian teratoma abdominal pain?

If a patient has an ovarian teratoma and also has abdominal pain, they should immediately visit a local hospital for a gynecological examination and a gynecological ultrasound. The main purpose is to confirm whether there is torsion of the ovarian teratoma. Once torsion of the ovarian teratoma occurs, it can cause ischemic necrosis of the ipsilateral fallopian tube and ovary, leading to severe consequences. Therefore, once an ovarian teratoma is detected, it is not advisable for the patient to continue observation treatment. Prompt surgery is key to avoiding pathological changes and complications.

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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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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.