teratoma (from the Greek meaning tératos - monster, a freak and -oma -opuhol) - a tumor mass, the developing of gonocytes that is localized mostly in the testicles in men, children intailbone, sacral region and the brain, ovaries in women.Teratoma is the organ or tissue, is atypical for the localization of tumors: it may be present bone tissue, muscle tissue, hair;much less the more complex organs: limbs, trunk, etc.
exact cause of teratoma is still not set, but the theoretical hypotheses exist.For example, a kind of theory - Fetus in fetu (the embryo is in the embryo), it is confirmed in practice during surgery.The inner content of the tumor - the body of the fetus.This occurs in multiple pregnancies, that is one fruit a strong, absorbs the other, genetically weaker.
The most popular is the theory, the essence of which is that the nature of germ cell teratoma.That is primary, gonadal germ cells of the embryo.Because these cells are formed three germ layers - t
further growth and development of the teratoma is a chromosomal abnormality of the cells themselves.As a result, the tumor is divided into mature (dermoid) and immature (teratoblastomy).The difference between them depends on the internal content.Mature is the one which consists of normal tissues inherent adult.Well, if it is impossible to differentiate the tissue, this indicates an immature form.In the context of tumor looks like a bag of hair content, fat, and sometimes the teeth.A microscopic examination can be good to see the formation of the embryo leaves.Ectodermal - skin, nervous tissue elements, such as ganglia.Mesoderm - bone, cartilage, fibrous and fatty tissue.Endoderm is rare, usually bronchial epithelium, thyroid and salivary glands.
mature cystic teratoma, one of the most common tumors in childhood and adolescence, and if teratogenicity high, the newborns fall into this category.Also not ruled out the risk of detection of reproductive age and postmenopausal.
What is a teratoma?Basically it is the single chamber, dual chamber only rarely, in most cases a benign form.
teratoma Symptoms may vary, depending on the localization and the time of its occurrence in embryogenesis.In most cases, teratoma may not occur for a long time and be in the "sleep" mode.Typically, this occurs at a adulthood.But if the tab of tumor cells occurs in the embryo, the proper development of the child is violated.And teratoma noticeable at birth as pathology of the skeleton and soft tissues.
characteristic and obvious symptoms appear teratoma with malignant course and tumor growth.These include - feeling of compression, shortness of breath and sometimes irregular heartbeat, fever in the localization of the tumor in the chest and lungs.If the development of teratomas occur in the ovary, then there is a feeling of heaviness in the lower abdomen, discomfort.
starting to show teratoma often at puberty, when hormonal changes occur.A sharp pain - a sign of torsion legs cyst, not rendered timely assistance to provoke the gap, and as a consequence - peritonitis.
When you are teratomas in the testis in men, it is visualized increase scrotal pain and signs indicate malignant course.It manifested in the age of 18-20 years.Most often, it is possible to determine immediately after birth and to remove about two months.If this does not work, then the outcome is not very favorable, as this age definition of perestroika hormonal already passed, and it is fraught with malignancy.The probability of transition of a tumor from a benign to a malignant increases.
Children teratoma observed in the perineum, coccyx and sacrum, disrupting normal activity and causing functional disorders of the urinary system and defecation.
sacral teratoma diagnosed immediately at birth, and it can be detected by ultrasound in utero yet.The neoplasm has a rounded shape, is located behind the sacrum, often large.There are problems with delivery, in such cases, doctors are inclined always to the caesarean section.
Less common teratoma mouth and throat, the neck, which can be determined in utero.They also cause complications during childbirth, as can occur asphyxia.
localization of the tumor in the retroperitoneal space manifests similar symptoms with gastrointestinal diseases, also joins nausea, vomiting.
Head brain, too, can become the location of the teratoma preferentially localized at the base of the skull and the epiphyseal region.Symptoms duplicated with signs of endocrine disorders clinic and damage brain structures.
This tumor of the ovary, which is formed from embryonic cells, dense consistency with dermoid hump on the surface.The tumor can be divided into two types - mature and immature teratoma.
immature teratoma often becomes malignant and metastatic disease and is accompanied by a disappointing outlook.Also, very often the wrong diagnosis, that is confused with teratoblastomoy teratoma.The structure consists of undifferentiated tumor tissues.There are signs of malignancy, development occurs much faster, and more rapidly, turning into teratoblastomu.The preferential localization in the anterior portion of the uterus.Such tumors susceptible to bleeding and necrotic.Metastasis occurs through blood or lymph, affecting nearby organs.Typical clinical manifestations - weakness, fatigue, anemia (hemorrhage), weight loss.Pain occur at a later stage.Therefore, early diagnosis is very important and timely surgical intervention.
mature teratoma is benign or as it is called - dermoid cyst consisting of one or more cavities.This formation consists of cartilage, bone and sebaceous elements, differing high density, but the structure is not uniform - contains multiple cystic vesicles that are filled with clear mucus.Not prone to metastasis, but the danger here torsion legs due to tumor size and the length of the legs.Formation of cysts varies from the prenatal period to maturity.The age criterion of detection ranges from 14 to 40 years.Throughout the period of unpredictable behavior of the teratoma, but usually reaches a certain size, it is no longer growing.
before pregnancy is best examined and, if necessary, to carry out treatment, by surgical intervention laporaskopicheskogo.Dermoid cyst, has not reached the size of 3 cm, it does not prevent pregnancy.But with the increase in size of the uterus, the risk of ovarian torsion and a cyst grows, and it threatens premature birth or miscarriage.The symptomatology may be different and depends on the size of the tumor.Usually the complaints begin with the pulling and arching pain in the abdomen.The larger tumors, the more symptoms and complaints.Disrupts the function of the bladder, the clinic is similar to cystitis.Due to the compression of the bowels, broken its normal functioning, pain intensified.By the evening, there may be a slight rise in temperature.
If not promptly seek medical care and do not start treatment teratoma possible complications.This may be bleeding, rupture of the cyst wall and out the contents into the pelvic cavity and peritonitis as a result.It may also occur compression of the surrounding tissues, torsion legs cyst or ovary.Therefore, if the doctor has diagnosed teratoma, you must carry out the operation without hesitation, because the tumor itself will not work and will not disappear.Timely intervention and the operation contributes to the overall recovery of the reproductive system, and after the rehabilitation period can safely plan pregnancy.
Usually the diagnosis of tumors is widely used method of ultrasound and screening conducted during pregnancy.After all, the sooner you can diagnose the pathology, the better you can prepare for a treatment strategy.
ultrasound as an informative diagnostic method that allows determining the size of a teratoma, a place of its location, as well as the structure, which is important for determining the stage of development, shape, presence of metastases.
Using X-ray performed panoramic, Biplane survey, also conducted X-ray method.This method is informative when mediastinal tumor and sacrococcygeal.
Computed tomography visualizes well the affected area, more accurately determine the size and structure, the presence of metastases and their location.
biopsy is performed by taking a puncture, to clarify the stage of the tumor and the presence of malignancy.
blood test is taken to determine the level of alpha-fetoprotein and human chorionic ganadotropina.However, this method specifies the presence of more than teratomas and is held on the grounds.
When teratoma of the ovary to start a manual inspection is carried out through the vagina.When a manual examination of the tumor is defined by the front, a dense consistency, painful on palpation.The size can be determined from about 5 to 15 cm.
ultrasound is used to confirm the diagnosis, during the observed acoustic pronounced polymorphism.Teratoma is hypoechoic structure, with clear contours and solitary echogenic inclusion.The inclusion of a well-traced acoustic shadow.
Another of the additional methods of investigation - DRC (color Doppler mapping).In mature tumors are almost always absent vascularization, blood flow can be seen in the surrounding and nearby tissues, but not there.
Any form teratoma treated only surgically, preferably immediately after its detection.And if there is ovarian torsion or legs, and bleeding in the abdominal cavity, the surgery is performed on an emergency basis.The volume of the transaction and date of teratomas depend on the size, the stage in which it is located and age criteria.For girls and women, for example, is carried out resection of the ovary, whereas in post-menopausal, the complete removal of the uterus and appendages.
When mature teratoma surgery is performed laparoscopically, the reproductive function is preserved.Forecast favorable in the majority of cases, relapse is possible radical method and chemotherapy.Malignant tumor is a complex form of treatment, including surgery, chemotherapy, and radiation.Chemotherapeutic process is carried out at least six courses, including drugs - Cisplatin, Platidiam, Platinol.It is also possible to include in the treatment of hormonal preparations, provided thereto sensitivity of tumor receptors.
The children also performed surgery, with complete elimination of teratomas.When coccygeal teratoma removed together with her coccyx.Deeper surgery is performed with the defeat of deep tissue, thus audited through the abdominal cavity.This operation is very difficult, as the affects of the gluteal and the perineum.If necessary, subsequently carried out corresponding cosmetic correction.Weather favorable, but the child must be monitored, with a tour of the perineum and rectum.
testicular teratoma treated successfully with timely diagnosis.But if there is metastasis and the tumor is an immature form, the prognosis is poor.A compulsory surgical intervention, if necessary, connect chemotherapy.