The difference between ovarian teratoma and cysts

Written by Du Rui Xia
Obstetrics
Updated on February 20, 2025
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Ovarian teratomas and ovarian cysts are two completely different diseases. Ovarian teratomas are caused by congenital factors and are tumors of the germ cells that can be benign or malignant, usually requiring surgical removal for treatment. Ovarian cysts, on the other hand, are caused by various factors in women, such as poor lifestyle habits or an imperfect diet structure, leading to a hormonal disease. Ovarian cysts can be physiological or pathological. Usually, physiological ovarian cysts gradually disappear with the menstrual cycle, while pathological ovarian cysts can also be benign or malignant. The need for surgical treatment depends on the nature, size, and clinical symptoms of the ovarian cyst.

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Written by Sun Shan Shan
Obstetrics and Gynecology
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Is surgery necessary for teratoma?

Ovarian teratoma belongs to a type of germ cell tumor. Ovarian teratomas can be classified into mature teratomas and immature teratomas. Mature teratoma, also known as dermoid cyst, is mostly a benign tumor. Within the cyst, components such as sebum, hair, teeth, and bone can be found. Additionally, mature teratomas have a malignant transformation risk of 2%-4% and are commonly seen in postmenopausal women. On the other hand, immature teratomas are malignant tumors, accounting for 1%-3% of ovarian teratomas and more commonly found in younger patients, with the average age ranging from 11 to 19 years old. Therefore, timely surgical treatment is necessary once an ovarian teratoma is detected.

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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 Wang Jing Hua
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Can teratoma affect menstruation?

The majority of teratomas do not have endocrine functions and will not affect menstrual cycles. If there is a delay in menstruation, the first step is to check for pregnancy. If menstruation is delayed for two weeks, pregnancy should be ruled out, and interventions might be necessary, such as an ultrasound to examine the endometrium or a progesterone withdrawal test. Teratomas do not cause menstrual delays unless a very small number of them have endocrine issues. However, these would not suddenly change the menstrual cycle but would potentially cause long-term endocrine changes from the time the teratoma is discovered.

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Written by Du Rui Xia
Obstetrics
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Are ovarian teratomas congenital?

Ovarian teratomas are congenital, primarily deriving from primordial germ cells. Teratomas consist of tissues from multiple embryonic layers, mostly being immature types. Most ovarian teratomas are cystic. Depending on the degree of tissue differentiation, teratomas can be classified as benign or malignant. Benign teratomas, also known as mature teratomas, are more common in women aged 20-40 and are usually unilateral and either round or ovoid in shape. A portion of these teratomas are malignant, typically found in younger patients, roughly aged 11-19 years, and this condition has a poorer prognosis, requiring timely surgical treatment.

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Written by Liu Jian Wei
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Do ovarian teratomas hurt?

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.