Teratoma

Presented by
Sivabavani Sadasivam
Santhakumari.B

Definition

Teratoma form the most common and

important group of fetal tumors.
Teratoma belong to a class of tumors
known as nonseminomatous
germ cell tumor (NSGCT).
Teratomas typically occur along the midline
of the body, anywhere from the coccyx to
the pineal gland.
Teratomas are composed of all three germ
cell layers (ectoderm, mesoderm, and
endoderm).

. derived from germ cells occur in the

testes in males and ovaries in females.

derived from embryonal cells usually

occur on the body midline: in the
brain, elsewhere inside the skull, in
the nose, in the tongue, under the
tongue, and in the neck (cervical
teratoma), mediastinum,
retroperitoneum, and attached to the
coccyx

Most common location is

sacrococcygeal (57%).
Cystic teratomas occasionally occur
in sequestered midline embryonic
cell rests and can be mediastinal
(7%),
retroperitoneal (4%),
cervical (3%),
intracranial (3%).
Examples include hair, teeth, fat,
skin, muscle, and endocrine tissue

Sacrococcygeal teratoma

initial sign of a fetal sacrococcygeal

teratoma may be increased uterine
fundal height.
Increased uterine size may result from
the mass itself or from associated
polyhydramnios.
Not all patients are symptomatic, with
some sacrococcygeal teratomas being
discovered during a routine obstetric
sonogram.

Most sacrococcygeal teratomas are

diagnosed in the second trimester, but
they have been detected as early as 13.5
weeks gestation .
Failure to diagnose during pregnancy can
have serious consequences for the fetus
and the mother.
Complications include premature delivery,
dystocia, intratumoral hemorrhage

Classification

Type I : the mass is external with

minimal or no internal components
Type II
:an external mass with
internal extension into the presacral
space.
Type III
:an external and internal
mass with extension into the abdominal
cavity.
Type IV
:entirely internal with no
external component

Diagnosis

detected by prenatal ultrasound

Elevated serum alpha-fetoprotein
(AFP) and beta-human chorionic
gonadotropin (HCG) levels may be
indicative of malignancy
CT scanning of the abdomen and
pelvis before surgical exploration

Management
Sacrococcygeal
teratomas
diagnosed prenatally should be
monitored closely.

Complete excision should be done

through a chevron-shaped buttock
incision

Prognosis

Recurrency of malignant tumor 15%

Follow up every 2-3 months for 3
years because recurrency normally
occurs after 3 years.