What to do about teratoma pain in the lower abdomen?

Written by Yan Qiao
Obstetrics and Gynecology
Updated on November 10, 2024
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Patients with teratomas experiencing lower abdominal pain require immediate attention. Due to the uneven texture of the teratoma itself, it can easily lead to torsion of the ovarian tumor pedicle as a result of changes in the patient's body position. Ovarian tumor pedicle torsion is a gynecological emergency requiring urgent surgical intervention. This is particularly crucial for young women who have not yet given birth, as early surgery can preserve the affected ovary, potentially improving future fertility chances. For older women, emergency surgery to relieve symptoms is also extremely important. Therefore, abdominal pain in patients with teratomas must be taken seriously.

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Written by Shen Li Wen
Obstetrics and Gynecology
1min 22sec home-news-image

How to Determine if a Teratoma is Benign

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 Yan Qiao
Obstetrics and Gynecology
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What should be paid attention to usually with teratoma?

For patients with teratoma, once the teratoma is detected, it is necessary to monitor it regularly. If the tumor is larger than three centimeters, it is best to undergo surgery as soon as possible. If surgery cannot be performed promptly due to particular reasons, then it is essential to have an ultrasound re-examination every three months. Additionally, patients should avoid vigorous exercise, external impacts, and significant changes in body position in daily life. Because teratomas are mixed masses with uneven textures, they are very prone to torsion. Therefore, significant changes in body position or vigorous exercises can easily cause the torsion of the pedicle, which may lead to the need for emergency surgery.

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Written by Wang Jing Hua
Obstetrics and Gynecology
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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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Written by Li Lin
Obstetrics and Gynecology
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The difference between teratoma and ovarian cysts

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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Written by Sun Shan Shan
Obstetrics and Gynecology
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Does a teratoma require surgery?

Ovarian teratomas are a type of germ cell tumor, requiring surgical treatment whether the teratoma is benign or malignant. Teratomas can be divided into mature teratomas and immature teratomas. Mature teratomas, also known as dermoid cysts, are considered benign tumors. Immature teratomas are malignant tumors, accounting for 1%-3% of ovarian teratomas. Mature teratomas are cystic with a single chamber filled with sebum and hair, and sometimes teeth and bone material can be found inside. Therefore, once a teratoma is identified, the choice of surgical method depends on the size of the tumor, and some biochemical tests are needed to determine the nature of the cystic tumor.