Various diagnostic methods for teratoma

The age of onset of teratoma ranges from newborns to women in their 90s. Ovarian teratoma is more likely to occur in young women in their twenties and thirties, and will gradually grow with age. Teratoma is not brought from the mother's body, but is a tumor that may erupt at any time. Many patients are caused by lack of knowledge about the disease, and many patients do not know how to diagnose teratoma. Let's take a look at the diagnostic examination methods for teratoma.

Teratoma is the most common ovarian tumor, accounting for 85% to 97%, and most of them are benign, accounting for 95%, and the malignant rate is 2% to 4%. The malignant tendency of teratoma increases with age.

Ovarian teratomas have two major characteristics: one is that they are common on both sides; the other is that they are prone to recurrence, with a recurrence rate of 2%. Teratomas mainly grow in the ovaries, but according to news reports, teratomas have also been found in the sacrum, head, throat, and other parts of the body.

1. X-ray diagnosis

Josephsen first diagnosed the tumor by radiographic examination in 1915, and this method has been used as a routine preoperative examination. Mature teratomas often contain oily substances, teeth, and bone fragments, so some characteristics can be shown in abdominal or pelvic X-rays, such as shadows of bone fragments and teeth, and calcified shadows of cyst contents. If the cyst contents are only sebum and hair, it will show a decrease in light transmittance or a round or oval shadow with a clear outline. Studies have shown that 41% to 62% of mature teratomas can show the above diagnostic features when examined by X-ray. In order to avoid confusion with gas in the intestinal loop, a bowel movement or colon wash should be performed before filming. In addition, it should also be differentiated from lesions with increased X-ray density in the pelvic cavity, such as uterine fibroids, ovarian fibroids, ureteral stones, and calcified lymph nodes.

2. Ultrasound diagnosis

Ultrasound examination of benign cystic teratoma can be divided into the following types of findings:

(1) Cystoid type: Most are round or oval in shape, with thick cyst walls, mostly single-chambered, with dense and highly reflective light spots inside, and sometimes a thin layer of liquid area can be seen on the inner wall.

(2) Intracystic dough sign: One or more light masses with strong reflectivity appear in the cyst. Most of them are round, but there are also irregular light masses. They may stick to the inner wall, and there is no echo behind the light masses.

(3) Intracystic hair sign: A round light mass can be seen in the cyst, with a crescent-shaped strong echo above it, which attenuates behind it and is accompanied by an obvious acoustic shadow (composed of a mass of lipids wrapped in a mass of hair).

(4) Intracystic fat-fluid stratification sign: The upper layer is highly reflective and has dense light spots, which is a layer of lipids; the lower layer is usually clear fluid, and sometimes a small number of light spots can be seen floating in the fluid. Between the two layers is the fat-fluid stratification plane. The fluid level of larger cysts may change with changes in body position.

(5) Complex type: The structure inside the cyst is complex, and may include light spots, lipid-fluid stratification, bright light clusters, hair cluster sign, and dough sign.

Warm reminder: Preoperative preparation for teratoma is to prepare the skin to clean the skin and prevent infection of the incision. The purpose of preoperative medication is to ensure sleep, induce anesthesia, enhance the anesthesia effect, and reduce glandular secretion. Gastrointestinal preparation prevents aspiration of vomitus during and after surgery, prevents accidental injury to the intestine during surgery, facilitates the smooth progress of the operation, and prevents abdominal distension after surgery.