Basic examination methods for teratoma

Teratoma belongs to germ cell tumors, which is a congenital tumor, divided into benign and malignant. The tumor tissue contains three histological types of endoderm, mesodermal and ectoderm tissues with well-differentiated or different degrees of malignancy. Due to different occurrence sites or metastasis, corresponding clinical manifestations are caused. What are the basic examination methods for teratoma?

Diagnostic tests for teratoma:

A clinical diagnosis can be made based on the clinical manifestations of teratomas in different locations and combined with the following examinations.

(1) X-ray of teratoma: Abnormal calcification can be seen in the tumor, such as the presence of teeth or irregular bone images, which are unique to teratoma. Chest and bone X-ray examinations can determine whether there is distant metastasis.

(2) Intravenous pyelography of teratoma: shows extrarenal tumors, and the renal ureter may be compressed, displaced or deformed.

(3) Ultrasound or CT examination of teratoma: determine whether the tumor is cystic, solid, or alternating between cystic and solid, and its relationship with surrounding tissues, and clarify the exact location and size of the tumor.

(4) MRI examination of teratoma: It can provide good contrast between normal and abnormal tissues, accurately show the spread within the long bone marrow, easily detect skipping metastases within the bone marrow, and determine the relationship between the tumor and the joints, nerves, and blood vessels, which is of great significance in determining the patient's treatment and prognosis.

(5) Determination of alpha-fetoprotein in teratoma: Malignant teratoma or malignant transformation of benign teratoma can cause an increase in alpha-fetoprotein. Its value can be used as a criterion for judging whether the tumor has become malignant. Recheck serum alpha-fetoprotein on the 3rd to 4th day and 2 to 3 weeks after surgery. If it exceeds 250μg/ml, it can be considered that malignant tissue remains.

(6) Rectal examination of teratoma: This is a very important examination that helps detect presacral tumors and can sense the degree of rectal compression, displacement, and even stenosis.

Differential diagnosis of teratoma:

(1) Retroperitoneal teratoma: needs to be differentiated from neuroblastoma, Wilms tumor, and hydronephrosis.

(2) Pelvic and sacrococcygeal teratomas: They should be differentiated from pelvic and bladder rhabdomyosarcomas. Cystic teratomas should be differentiated from meningoceles. Cystography, X-rays to check for spina bifida, and alpha-fetoprotein measurements can be performed.

(3) Testicular teratoma: It is easy to misdiagnose as testicular hydrocele, orchitis and testicular hematoma (traumatic). Care should be taken to inquire about the medical history, perform a light transmission test, pay attention to the presence of tenderness during the examination, and perform an alpha-fetoprotein test.

(4) Ovarian teratoma: When patients seek medical attention with acute abdominal symptoms, it is easy to be misdiagnosed as acute appendicitis. When patients seek medical attention with abdominal masses, they should be differentiated from mesenteric cysts, omental cysts, and enlarged bladders. Ultrasound or CT scans can confirm the diagnosis.