How to diagnose teratoma

Teratoma is a benign gynecological tumor. Speaking of teratoma, I believe you will show an expression that you have never heard of it. After all, this is a disease that is not very common in life. Experts say that teratoma deteriorates quickly, and we should go to the hospital for treatment as soon as possible when we find it. So, how to diagnose teratoma?

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(1) Serum alpha-fetoprotein (AFP) The serum AFP of patients is lower than that of ovarian yolk sac tumor. This may be because the endoderm tissue of immature teratoma can also secrete a small amount of AFP. Another possibility is that many germ cell malignancies are mixed types. Immature teratoma may contain a small amount of yolk sac tumor components, which can synthesize trace amounts of AFP.

(2) Nerve cell specific enolase (NSE): Ovarian immature teratoma contains mature or immature nerve cells. Sometimes NSE can be detected in the serum, which is of reference value for the diagnosis of this disease.

(3) Other examinations including B-ultrasound, CT, MRI, laparoscopy, and histopathology.

Inspection criteria:

Most teratomas are exophytic or have palpable masses, and early diagnosis is often possible based on clinical manifestations. Careful abdominal examination and pulmonary teratoma angiography.

Rectal examination is very necessary for the examination of abdominal, pelvic and occult sacrococcygeal teratomas. X-ray films of the tumor site can reveal abnormal calcifications of bones and teeth in the tumor to confirm the teratoma, which is mostly mature teratoma. Gastrointestinal barium meal, barium enema and intravenous pyelography can understand the compression and displacement of the gastrointestinal tract or organs such as kidneys, ureters and bladder in the corresponding parts. CT and MRI examinations should be performed for teratomas that grow rapidly and have a wide range of infiltration to clarify the range of tumor infiltration and its adjacent relationship with important blood vessels and spinal nerves.

If a malignant teratoma is considered, the serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) levels should be tested for diagnosis and prognosis. 92% of malignant teratomas have elevated alpha-fetoprotein, while 4% of benign teratomas have abnormal AFP. It was found that patients with elevated AFP in benign teratomas had a significantly increased recurrence rate after surgery.

Spine X-rays show a large or obvious widening of the intervertebral cavity, narrow pedicles at the site of the lesion, widened interpedicular distance, concavity of the posterior edge of the vertebral body, and in some cases, manifestations of spina bifida.

CT and MRI have obvious advantages in diagnosing teratomas, and both can better show the heterogeneity of tumors. On MRI images, teratomas appear as mixed signals, often with intact cyst walls, rich in fat signals, with or without intratumoral enhancement nodules, and usually, in addition to the tumor, are often accompanied by spina bifida or vertebral dysplasia.