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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How is a teratoma diagnosed?

Teratomas mostly occur on the ovaries. Ovarian tumors generally do not show symptoms in their early stages or when they are small. They are usually discovered during physical examinations, and identified through ultrasound, which will indicate a cystic mass or a cystic-solid mass on the ovaries. Subsequently, serum tumor markers are tested to see if there is an increase. Some patients with teratomas may show a slight increase in alpha-fetoprotein. Further diagnostic steps include a pelvic MRI, which can very clearly display the nature of the tumor and some of the components within the tumor. The most common findings in teratomas include elements like hair and bones. Ultimately, a definitive diagnosis relies on pathological examination.

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Written by Xu Xiao Ming
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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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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 Shen Li Wen
Obstetrics and Gynecology
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Can ovarian teratomas affect menstruation?

Women with ovarian teratomas, when they are relatively small, usually do not affect the menstrual cycle. However, as they grow larger, they may compress the normal ovarian cortex, leading to abnormal ovulation, abnormal hormone secretion levels, disruption of the menstrual cycle, and can also cause difficulties in getting pregnant. Additionally, ovarian teratomas belong to germ cell tumors, which are multi-layered but can also develop into a single layer. Some teratomas are highly single-layered and can secrete certain hormones that affect women's endocrine system, thereby affecting the menstrual cycle.

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Written by Shen Li Wen
Obstetrics and Gynecology
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What is the cause of the pain from a teratoma?

Female teratomas are cystic-solid tumors located on the ovaries. When they are small in size, they generally do not cause pain. However, as they grow larger, due to gravitational pull, they stretch the surrounding ligaments, causing women to experience hidden pain on one side of the lower abdomen. This pain is bearable and only intensifies after vigorous activities or intercourse. Some women may experience increased pain if they have a pelvic infection or during menstruation. Because teratomas are uneven in texture, if they are not adherent to surrounding structures and are relatively mobile, and their stalk is thinner, they might twist under certain circumstances, such as rolling over, spinning hula hoops, or during pregnancy, when the uterus grows and changes the position of the teratoma, leading to acute lower abdominal pain from torsion of the teratoma’s stalk. Therefore, when a woman experiences abdominal pain from a teratoma, it is essential to conduct a gynecological examination and pelvic ultrasound to understand the specific cause of the pain.