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| Caption = Mature teratoma. [[H&E stain]]. | | Caption = Mature teratoma. [[H&E stain]]. | ||
| Micro = classically all three [[germ layers]]: endoderm (skin, (mature) CNS), mesoderm (muscle, bone, connective tissue, blood), ectoderm (internal organs) | | Micro = classically all three [[germ layers]]: endoderm (skin, (mature) CNS), mesoderm (muscle, bone, connective tissue, blood), ectoderm (internal organs) | ||
| Subtypes = [[mature teratoma]], [[immature teratoma]], [[ | | Subtypes = [[mature teratoma]], [[immature teratoma]], [[strumal carcinoid]], [[struma ovarii]] | ||
| LMDDx = [[mixed germ cell tumour]], [[squamous cell carcinoma]] | | LMDDx = [[mixed germ cell tumour]], [[squamous cell carcinoma]] | ||
| Stains = | | Stains = | ||
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}} | }} | ||
'''Teratoma''' is a common [[germ cell tumour]]. Most are benign. Some are malignant. Some are quite weird. | '''Teratoma''' is a common [[germ cell tumour]]. Most are benign. Some are malignant. Some are quite weird. | ||
==General== | |||
*May be benign or malignant. | *May be benign or malignant. | ||
*Are supposed to consists of all three [[germ layers]] - this is not always true. | *Are supposed to consists of all three [[germ layers]] - this is not always true. | ||
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**Mature teratomas may have a benign or malignant behaviour. | **Mature teratomas may have a benign or malignant behaviour. | ||
===Classification=== | |||
#Mature. | #Mature. | ||
#*Common in females. | #*Common in females. | ||
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#*Highly specialized. | #*Highly specialized. | ||
==Mature teratoma== | |||
Features - three germ cell layers (usually):<ref>{{cite book |author=Moore, Keith L.; Persaud, T.V.N.|title=The Developing Human: Clinically Oriented Embryology |publisher=Saunders |location= |year=2002 |pages= 83 |edition=7th |isbn=978-0721694122 |oclc= |doi= |accessdate=}}</ref> | Features - three germ cell layers (usually):<ref>{{cite book |author=Moore, Keith L.; Persaud, T.V.N.|title=The Developing Human: Clinically Oriented Embryology |publisher=Saunders |location= |year=2002 |pages= 83 |edition=7th |isbn=978-0721694122 |oclc= |doi= |accessdate=}}</ref> | ||
#Endoderm: | #Endoderm: | ||
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*May consist of skin only - in which case it is commonly called a ''dermoid''. | *May consist of skin only - in which case it is commonly called a ''dermoid''. | ||
====Images==== | |||
<gallery> | <gallery> | ||
Image:Teratoma_2_low_mag.jpg | Mature teratoma - low mag. (WC/Nephron) | Image:Teratoma_2_low_mag.jpg | Mature teratoma - low mag. (WC/Nephron) | ||
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</gallery> | </gallery> | ||
===Fetus in fetu=== | |||
*Grouped with ''mature teratoma'', as it is considered a well-developed mature teratoma.<ref name=pmid3045784>{{Cite journal | last1 = Heifetz | first1 = SA. | last2 = Alrabeeah | first2 = A. | last3 = Brown | first3 = BS. | last4 = Lau | first4 = H. | title = Fetus in fetu: a fetiform teratoma. | journal = Pediatr Pathol | volume = 8 | issue = 2 | pages = 215-26 | month = | year = 1988 | doi = | PMID = 3045784 }}</ref><ref name=pmid17183856>{{Cite journal | last1 = Basu | first1 = A. | last2 = Jagdish | first2 = S. | last3 = Iyengar | first3 = KR. | last4 = Basu | first4 = D. | title = Fetus in fetu or differentiated teratomas? | journal = Indian J Pathol Microbiol | volume = 49 | issue = 4 | pages = 563-5 | month = Oct | year = 2006 | doi = | PMID = 17183856 }}</ref> | *Grouped with ''mature teratoma'', as it is considered a well-developed mature teratoma.<ref name=pmid3045784>{{Cite journal | last1 = Heifetz | first1 = SA. | last2 = Alrabeeah | first2 = A. | last3 = Brown | first3 = BS. | last4 = Lau | first4 = H. | title = Fetus in fetu: a fetiform teratoma. | journal = Pediatr Pathol | volume = 8 | issue = 2 | pages = 215-26 | month = | year = 1988 | doi = | PMID = 3045784 }}</ref><ref name=pmid17183856>{{Cite journal | last1 = Basu | first1 = A. | last2 = Jagdish | first2 = S. | last3 = Iyengar | first3 = KR. | last4 = Basu | first4 = D. | title = Fetus in fetu or differentiated teratomas? | journal = Indian J Pathol Microbiol | volume = 49 | issue = 4 | pages = 563-5 | month = Oct | year = 2006 | doi = | PMID = 17183856 }}</ref> | ||
**It has been suggested they are distinct from teratomas.<ref>{{Cite journal | last1 = Basu | first1 = A. | last2 = Jagdish | first2 = S. | last3 = Iyengar | first3 = KR. | last4 = Basu | first4 = D. | title = Fetus in fetu or differentiated teratomas? | journal = Indian J Pathol Microbiol | volume = 49 | issue = 4 | pages = 563-5 | month = Oct | year = 2006 | doi = | PMID = 17183856 }}</ref> | **It has been suggested they are distinct from teratomas.<ref>{{Cite journal | last1 = Basu | first1 = A. | last2 = Jagdish | first2 = S. | last3 = Iyengar | first3 = KR. | last4 = Basu | first4 = D. | title = Fetus in fetu or differentiated teratomas? | journal = Indian J Pathol Microbiol | volume = 49 | issue = 4 | pages = 563-5 | month = Oct | year = 2006 | doi = | PMID = 17183856 }}</ref> | ||
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**Separated from teratoma by the presence of a vertebral column.<ref name=pmid17334616>{{Cite journal | last1 = Majhi | first1 = AK. | last2 = Saha | first2 = K. | last3 = Karmakar | first3 = M. | last4 = Sinha Karmakar | first4 = K. | last5 = Sen | first5 = A. | last6 = Das | first6 = S. | title = Fetus in fetu--a mystery in medicine. | journal = ScientificWorldJournal | volume = 7 | issue = | pages = 252-7 | month = | year = 2007 | doi = 10.1100/tsw.2007.56 | PMID = 17334616 }}</ref> | **Separated from teratoma by the presence of a vertebral column.<ref name=pmid17334616>{{Cite journal | last1 = Majhi | first1 = AK. | last2 = Saha | first2 = K. | last3 = Karmakar | first3 = M. | last4 = Sinha Karmakar | first4 = K. | last5 = Sen | first5 = A. | last6 = Das | first6 = S. | title = Fetus in fetu--a mystery in medicine. | journal = ScientificWorldJournal | volume = 7 | issue = | pages = 252-7 | month = | year = 2007 | doi = 10.1100/tsw.2007.56 | PMID = 17334616 }}</ref> | ||
==Immature teratoma== | |||
Features: | Features: | ||
*Immature if neural tissue is present:<ref>RS. 2 May 2010.</ref> | *Immature if neural tissue is present:<ref>RS. 2 May 2010.</ref> | ||
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*[[Retina]]. | *[[Retina]]. | ||
====Images==== | |||
<gallery> | <gallery> | ||
Image:Immature_teratoma_high_mag.jpg | Primitive neuroepithelium - high mag. (WC/Nephron) | Image:Immature_teratoma_high_mag.jpg | Primitive neuroepithelium - high mag. (WC/Nephron) | ||
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*[http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0C001-PQ01-M.htm Immature teratoma - primitive neuroepithelium (ouhsc.edu)]. | *[http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0C001-PQ01-M.htm Immature teratoma - primitive neuroepithelium (ouhsc.edu)]. | ||
===Grading (immature)=== | |||
Based on quantity of immature neuroepithelium:<ref name=pmid17080330>{{cite journal |author=Harms D, Zahn S, Göbel U, Schneider DT |title=Pathology and molecular biology of teratomas in childhood and adolescence |journal=Klin Padiatr |volume=218 |issue=6 |pages=296–302 |year=2006 |pmid=17080330 |doi=10.1055/s-2006-942271 |url=}}</ref><ref name=pmid15761467>{{cite journal |author=Ulbright TM |title=Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues |journal=Mod. Pathol. |volume=18 Suppl 2 |issue= |pages=S61–79 |year=2005 |month=February |pmid=15761467 |doi=10.1038/modpathol.3800310 |url=http://www.nature.com/modpathol/journal/v18/n2s/full/3800310a.html}}</ref><ref name=pmid7814189>{{cite journal |author=O'Connor DM, Norris HJ |title=The influence of grade on the outcome of stage I ovarian immature (malignant) teratomas and the reproducibility of grading |journal=Int. J. Gynecol. Pathol. |volume=13 |issue=4 |pages=283–9 |year=1994 |month=October |pmid=7814189 |doi= |url=}}</ref> | Based on quantity of immature neuroepithelium:<ref name=pmid17080330>{{cite journal |author=Harms D, Zahn S, Göbel U, Schneider DT |title=Pathology and molecular biology of teratomas in childhood and adolescence |journal=Klin Padiatr |volume=218 |issue=6 |pages=296–302 |year=2006 |pmid=17080330 |doi=10.1055/s-2006-942271 |url=}}</ref><ref name=pmid15761467>{{cite journal |author=Ulbright TM |title=Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues |journal=Mod. Pathol. |volume=18 Suppl 2 |issue= |pages=S61–79 |year=2005 |month=February |pmid=15761467 |doi=10.1038/modpathol.3800310 |url=http://www.nature.com/modpathol/journal/v18/n2s/full/3800310a.html}}</ref><ref name=pmid7814189>{{cite journal |author=O'Connor DM, Norris HJ |title=The influence of grade on the outcome of stage I ovarian immature (malignant) teratomas and the reproducibility of grading |journal=Int. J. Gynecol. Pathol. |volume=13 |issue=4 |pages=283–9 |year=1994 |month=October |pmid=7814189 |doi= |url=}}</ref> | ||
*G0 - mature teratoma; no immature neuroepithelium. | *G0 - mature teratoma; no immature neuroepithelium. | ||
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*LPF not adequately defined - see [[LPFitis]]. Same BS as HPF. | *LPF not adequately defined - see [[LPFitis]]. Same BS as HPF. | ||
===IHC (immature)=== | |||
Features: | Features: | ||
*Primitive neuroepithelium:<ref name=pmid11598856>{{cite journal |author=Craver RD, Lipscomb JT, Suskind D, Velez MC |title=Malignant teratoma of the thyroid with primitive neuroepithelial and mesenchymal sarcomatous components |journal=Ann Diagn Pathol |volume=5 |issue=5 |pages=285–92 |year=2001 |month=October |pmid=11598856 |doi=10.1053/adpa.2001.27918 |url=}}</ref> | *Primitive neuroepithelium:<ref name=pmid11598856>{{cite journal |author=Craver RD, Lipscomb JT, Suskind D, Velez MC |title=Malignant teratoma of the thyroid with primitive neuroepithelial and mesenchymal sarcomatous components |journal=Ann Diagn Pathol |volume=5 |issue=5 |pages=285–92 |year=2001 |month=October |pmid=11598856 |doi=10.1053/adpa.2001.27918 |url=}}</ref> | ||
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**Synaptophysin +ve. | **Synaptophysin +ve. | ||
==Monodermal teratomas== | |||
===Struma ovarii=== | |||
Features: | Features: | ||
*Thyroid tissue present - colloid is seen. | *Thyroid tissue present - colloid is seen. | ||
**May develop pathologies seen in the [[thyroid gland]], e.g. [[papillary thyroid carcinoma]]. | **May develop pathologies seen in the [[thyroid gland]], e.g. [[papillary thyroid carcinoma]]. | ||
====Images==== | |||
<gallery> | <gallery> | ||
Image:Struma_ovarii_-_low_mag.jpg | Struma ovarii - low mag. (WC/Nephron) | Image:Struma_ovarii_-_low_mag.jpg | Struma ovarii - low mag. (WC/Nephron) | ||
Image:Struma_ovarii_-_high_mag.jpg | Struma ovarii - high mag. (WC/Nephron) | Image:Struma_ovarii_-_high_mag.jpg | Struma ovarii - high mag. (WC/Nephron) | ||
</gallery> | </gallery> | ||
===Strumal carcinoid=== | |||
Features:<ref name=pmid18509188>{{Cite journal | last1 = Gorin | first1 = I. | last2 = Sastre-Garau | first2 = X. | title = Strumal carcinoid tumor of the ovary. | journal = J Clin Oncol | volume = 26 | issue = 16 | pages = 2780-1 | month = Jun | year = 2008 | doi = 10.1200/JCO.2008.16.1620 | PMID = 18509188 }}</ref><ref>{{Cite journal | last1 = Tamsen | first1 = A. | last2 = Mazur | first2 = MT. | title = Ovarian strumal carcinoid in association with multiple endocrine neoplasia, type IIA. | journal = Arch Pathol Lab Med | volume = 116 | issue = 2 | pages = 200-3 | month = Feb | year = 1992 | doi = | PMID = 1346363 }}</ref> | Features:<ref name=pmid18509188>{{Cite journal | last1 = Gorin | first1 = I. | last2 = Sastre-Garau | first2 = X. | title = Strumal carcinoid tumor of the ovary. | journal = J Clin Oncol | volume = 26 | issue = 16 | pages = 2780-1 | month = Jun | year = 2008 | doi = 10.1200/JCO.2008.16.1620 | PMID = 18509188 }}</ref><ref>{{Cite journal | last1 = Tamsen | first1 = A. | last2 = Mazur | first2 = MT. | title = Ovarian strumal carcinoid in association with multiple endocrine neoplasia, type IIA. | journal = Arch Pathol Lab Med | volume = 116 | issue = 2 | pages = 200-3 | month = Feb | year = 1992 | doi = | PMID = 1346363 }}</ref> | ||
*Has components that suggest: | *Has components that suggest: | ||
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*#[[Thyroid]] - cystic spaces/follicular-like structures. | *#[[Thyroid]] - cystic spaces/follicular-like structures. | ||
====Images==== | |||
<gallery> | <gallery> | ||
Image:Strumal_carcinoid_-_intermed_mag.jpg | Strumal carcinoid - intermed. mag. (WC/Nephron) | Image:Strumal_carcinoid_-_intermed_mag.jpg | Strumal carcinoid - intermed. mag. (WC/Nephron) | ||
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</gallery> | </gallery> | ||
==Sign out== | |||
===Mature teratoma=== | |||
<pre> | <pre> | ||
CYST ("DERMOID"), RIGHT OVARY, CYSTECTOMY: | CYST ("DERMOID"), RIGHT OVARY, CYSTECTOMY: | ||
- MATURE CYSTIC TERATOMA. | - MATURE CYSTIC TERATOMA. | ||
</pre> | </pre> | ||
==See also== | ==See also== |
edits