Teratoma
Introduction
Introduction to teratoma Teratomas are tumors derived from germ cells with multi-directional differentiation potential, often containing a variety of tissue components of three germ layers, and the arrangement is disordered. According to its appearance, it can be divided into two types: cystic and solid: according to the different degree of tissue differentiation and maturity, it can be divided into benign teratoma and malignant teratoma. This tumor most often occurs in the ovaries and testes. Occasionally found in the mediastinum, appendix, peritoneum, pineal body and other parts. (1) benign teratoma: mostly cystic, it is also known as cystic teratoma, or called dermoid cyst, more common in the ovary. Most of the tumors are single-atrial, the inner wall is granules, rough and uneven, often with nodular bulges. Sometimes you can see small bones, cartilage, etc., there are sebum, hair, and even visible teeth in the cyst. Under the microscope, in addition to skin tissue and skin attachments, glandular, tracheal or intestinal mucosa, bone, cartilage, brain, smooth muscle, thyroid and other tissues covered with cubic epithelium can be seen. Various tissues are basically differentiated and mature, so they are known as mature teratoma. Benign teratoma has a good prognosis, and a few abominable squamous cell carcinomas. (2) malignant teratoma: mostly solid, more common in the testis than the ovary. It is mainly composed of embryonic tissue that is immature and differentiated. It is often a poorly differentiated neuroectodermal component, so it is also called immature teratoma. This tumor often metastasizes and can transfer pelvic and distant organs. basic knowledge The proportion of sickness: 0.2% - 0.3% Susceptible people: infants and young children Mode of infection: non-infectious Complications: vertebral tuberculosis
Cause
Teratoma cause
Congenital dysplasia (45%):
The embryonic cells remaining in the embryonic development of the embryonic tissue in the spinal canal are developed into epidermoid cysts, dermoid cysts, teratoid cysts and teratomas. The first two are Occurred by ectodermal tissue, the teratoma contains three germ layer structures, and the teratoid cyst contains two germ layer structures.
External factors (25%):
Expectant mothers encounter some environmental hazards when gestating the fetus, such as radiation, second-hand smoke, drugs, tobacco and alcohol, etc. are not conducive to the growth and development of the fetus, easy to cause deformity.
Prevention
Teratoma prevention
The cause of teratoma is caused by abnormal embryonic development during fetal embryonic period, which is generally congenital. Therefore, factors that may affect the growth and development of the fetus may lead to teratoma, so the expectant mother must avoid some when gestating the fetus. Hazards, such as radiation, second-hand smoke, drugs, tobacco and alcohol, are not conducive to the growth and development of the fetus. In addition, we must ensure a balanced nutrition and a happy mood. In short, strong prenatal education is a good protection for the baby. Pregnancy tests and regular pregnancy tests are the means to detect fetal development.
Complication
Teratoma complications Complications
Teratomas are usually isolated from a single disease, but some cases may still have congenital malformations. Some appendix teratoma combined with Currarino triad (anorectal malformation, tibial dysplasia, and anterior tibial mass); other related reports of genitourinary malformations (hypospadias, vesicoureteral reflux, double vagina or uterus, etc.) ), congenital dislocation of the hip, central nervous system lesions (no brain, Dandy-Walker malformation, spina bifida and spinal meningocele). Klinefelter's syndrome (closely related to mediastinal teratoma), in addition to very rare syndromes such as: 13 trisomy, trisomy 21, Morgagni's hernia, congenital heart disease, BeckwithWiedemann syndrome, wing Clam meat, cleft lip, cleft palate, etc., and less common Proteus and SchinzelGiedion syndrome.
Symptom
Teratoma symptoms common symptoms dull pain sensory disorder bladder dysfunction severe radiculopathy sphincter dysfunction
Teratoma has various symptoms and manifestations in the clinic because of different parts, often multiple complications and obvious malignant tendency:
Painless mass: This is the most common symptom of teratoma, mostly round cystic, clear boundary, soft and hard texture, and even bony nodules. Among them, exogenous tumors are common in the midline of the appendix, occipital, frontal and nasal. The teratoma of the appendix can be divided into three clinical types: phenotype, invisible and mixed according to their location.
Compression and airway obstruction symptoms: mediastinal teratoma often compresses the respiratory tract and causes cough, dyspnea and jugular vein engorgement; post-peritoneal teratoma often has abdominal pain and can cause intestinal obstruction. The pelvic and appendix invisible teratoma are often treated for constipation, difficulty in defecation, and urinary retention.
Acute symptoms: ovary, testicular teratoma can occur ovarian or testicular torsion, necrosis, manifested as severe pain and corresponding local symptoms; teratoma when secondary infection and intracapsular hemorrhage, often can rapidly increase the mass, local Significant tenderness, accompanied by fever, anemia, shock and other systemic infections or blood loss symptoms; retroperitoneal, ovarian, pelvic, appendix and other parts of the tumor can also suddenly rupture and severe bleeding, bloody abdomen, shock and other dangerous performance.
Symptoms of tumor malignancy: malignant teratoma and benign teratoma malignant, often manifested as rapid tumor growth, loss of original elasticity, exogenous tumor visible superficial venous engorgement, congestion, local skin infiltration and skin temperature Increase. It can be metastasized by lymph and blood and has lymph node enlargement and symptoms of lung and bone metastasis. At the same time, systemic symptoms such as weight loss, anemia and tumor fever occur.
Examine
Teratoma examination
The spine X-ray showed a wide range or obvious vertebral stenosis, the pedicle of the lesion was narrow, the pedicle spacing was widened, and the posterior margin of the vertebral body was concave. In some cases, the performance of spina bifida was observed.
CT and magnetic resonance have obvious advantages in the diagnosis of teratoma, and they can better show the heterogeneity of the tumor. On the magnetic resonance imaging, the teratoma shows a mixed signal, often with a complete cyst wall and rich in fat. Signals, with or without intratumoral enhanced nodules, usually with the exception of tumors, with spina bifida or vertebral dysplasia.
Diagnosis
Diagnosis of teratoma
diagnosis
The diagnosis of intraspinal teratoma is not difficult in the era of development of magnetic resonance imaging technology. MRI can accurately determine the location, size, tumor characteristics and development of adjacent spinal cord, and the diagnosis and prognosis of the surgical plan. It is of great significance.
For patients with intracranial inflammation, especially recurrent episodes, with sinus in the lower back, the diagnosis of this disease should be considered first. For the presence of low back pain, the medical history is longer, the age is lighter, and the lower extremity movement and sensory disturbance and size If you have dysfunction, you should be alert to the possibility of this disease, as soon as possible, chest and lumbar vertebrae MRI, in order to confirm the diagnosis.
Differential diagnosis
When there is no bone component in the teratoma, it is usually not possible to distinguish from the dermoid cyst and the epidermoid cyst in imaging.
