Ovarian teratomas are usually benign neoplastic changes, characterized by the structure of disordered, mixed tissues. They are classified according to the degree of cell differentiation into mature and immature teratomas. Due to the lack of specific symptoms, they are usually detected during routine imaging tests. What is the treatment of ovarian teratomas?
Ovarian teratomasbelong to a group of neoplasms originating from polypotent germ cells (germ cells), which can differentiate into almost all types of tissues in the body. This origin explains the unusual appearance of these tumors, consisting of a tangle of randomly mixed tissues from all three germ layers that make up hair, bones and nails. There is a reason why the Latin name of teratomas - teratoma - means a monster, a wonder or a miracle. These types of neoplastic changesare most often diagnosed in young women, between the ages of 20 and 30 . Usually the tumor grows on one of the ovaries, mainly the right one, but occasionally it may develop on both sides.
Ovarian teratomas - division
The classification of ovarian teratomas is based on the degree of differentiation and maturity of the cells that compose it.
Potworniak mature
Mature teratomais the most common type of tumor. In the vast majority of cases, these changes are benign, and only about 1-2% of teratomas of this type may undergo secondary malignancy. Such rare cases usually occur in perimenopausal women.
Mature teratomas usually take the form of the so-called a dermal (dermoid) cyst.The tumor may be 10 to 15 cm in diameter .
A characteristic feature of the structure of this type of neoplastic lesions is the high degree of cell differentiation, which is why in the interior of the cyst it is often possible to identify the seeds of bones, teeth, nails, sebaceous glands, and even whole tufts of long, curled hair.
It is estimated that mature ovarian teratomas constitute about 10-20% of all ovarian neoplastic lesions diagnosed in women. They are also the most common neoplastic lesion of the ovarydetected in young girls under the age of 20.
Immature teratoma
Immature teratomais characterized by a very low degree of cell differentiation. Most often it has a solid structure, where hair or teeth are unlikely to be found, unlike in the case of mature teratomas.
These tumors are diagnosed mainly in young female patients around 18 years of age. Because in general, the degree of malignancy of tumors is inversely proportional to the degree of differentiation of the cells that compose them. Immature teratomas are usually malignant.
Teratomas - symptoms
Most teratomas do not show obvious symptoms and are most often detected by accident during ultrasound examination in a gynecological office.
Undiagnosed cysts can sometimes contribute todifficulty getting pregnant . More advanced changes, by increasing their diameter, will cause the feeling of non-specific symptoms, such as:
- abdominal pain
- general feeling of fullness
- flatulence
- nausea
- genital bleeding
- urge to urinate
In rare cases, the presence of teratoma may lead to complications in the form of the so-called twist of the ovary, resulting in reduced blood flow to the fallopian tube and ovary. The symptoms of this syndrome are usually sharp, sudden pain in the lower abdomen, high fever or vomiting.
Potworniaki - diagnosis
If a tumor of the appendages is detected during a routine visit to the gynecologist or during another procedure, the attending physician will order a more detailed imaging diagnosis of the suspected lesion.
The most frequently used tests here will be:
- transvaginal ultrasound
- or computed tomography (CT) that emits X-rays.
A thorough assessment of the photos taken by a specialist will allow you to classify the tumor.The presence of ovarian teratoma will be indicated by the formations inside the cyst , visible as calcifications and bone ovules.
Potworniaki - treatment
Mature ovarian teratomas are tumors with a very slow growth(about 1-2 mm per year). Therefore, in the case of lesions less than 7 cm in diameter, many specialists recommend systematic, annual monitoring of the tumor and refraining from the operation.
Larger tumors may run the risk of rupturingand causing severe complications, including peritonitis. The procedure of selecting larger teratomas is surgical removal.
Currently, in the absence of otherscontraindications, it is preferable to perform laparoscopic surgery. The undoubted advantages of this solution are the shorter duration of the procedure itself, small scars and faster recovery of the patient.
As with the removal of all suspected cancerous lesions, the excised tissue will be submitted for histopathological examination to assess the status of cell differentiation and appearance. Only the final result of this examination provides the basis for the diagnosis of teratoma.
Detectionimmature teratoma , with a higher possibility of malignant malignancy, most often requires the removal of the ovary, and even (in elderly women who are not planning to have children) the entire uterus with appendages.
This cancer can spread to nearby lymph nodes, the peritoneum, and even, along with the bloodstream, to distant organs such as the liver or lungs. Therefore, adjuvant chemotherapy may also be required at times.
If you are diagnosed withmature teratomasuch a radical approach is not necessary. However, regular gynecological ultrasound is recommended to avoid tumor recurrence.
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