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Teratoma

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.

Overview

Overview


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Template:Masoud Bitarafn

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Xyz from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

References


Template:WikiDoc Sources

Historical Perspective

Historical Perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Masoud Bitarafan, M.D[[2]]

Overview

Historical Perspective

The earliest report of teratoma goes back to 600 to 900 BC from the Chaldean Royal Library of Nineveh where the general features of teratomas were listed on clay tablet. In the following centuries teratomas were further characterized to be embryoid in nature with the discovery of a growth that contained pigmented optic cups and a skull. However, in 1856 teratoma is fully defined as abnormal tumor with the three germ layers—mesoderm, ectoderm, and endoderm—which recapitulate tissue types derived from each layer.[1]

The recognition of teratomas stretches in time from fragmentary descriptions in ancient times to increasingly frequent gross anatomical observations in the 17th, 18th, and 19th centuries. Clinical observations of the biologic behavior of teratomas likewise expanded from isolated descriptions of patients with tumors in various locations to reports of series of cases with increasing knowledge of clinical signs and symptoms. The understanding of the genesis of these tumors, initially attributed to demons and various forms of sexual misbehavior, languished half-buried under the weight of 19th century speculations (Pauly, 1875) until experimental biologists working in the past 15–20 yr began to unravel some of the mysteries of germ cell development and cellular differentiation.[2]

The term “teratoma” derives from the Greek word “τέρατα,” which literally translates as “monsters.” A “teratoma” therefore is a “monster tumor” or “monster growth,” and it is apparent that the same root gives rise to “teratogenic,” which therefore translates to “monster forming.” In all probability “teratoma” was first applied to the circumstance of a malformed, monozygotic twin that was fused to an external body site of its genetically identical sib. This condition, today, is frequently termed “fetus in fetu.” Thus, the original “teratoma” referred to a congenital malformation, but it probably was relatively quickly adapted to what we would now regard as a true neoplasm rather than a malformation, namely the sacrococcygeal teratoma of infancy, because it, too, commonly appears as a “monstrous” protrusion from an external body site, although it is rarely fetiform.[3]



References

  1. ↑ “Embryonic stem (ES) cells and embryonal carcinoma (EC) cells: opposite sides of the same coin | Biochemical Society Transactions”.
  2. ↑ “pdfs.semanticscholar.org” (PDF).

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Classification

Classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2], Masoud Bitarafan, M.D[[3]]Amandeep Singh M.D.[4]

Overview

Teratomas are subtypes of germ cell tumors.Teratomas may be classified into four subgroups based on the histology and site features.

Classification

  • Teratomas may be classified into four subgroups based on the histology features.[1][2][3]
    • Mature teratoma which is benign cystic and solid.
    • Immature teratoma which is malignant with some embryonic component.
    • Malignant teratoma with some somatic malignant neoplasm component.
    • Monodermal teratoma.
  • Teratomas may also be classified based on the site:[4]
    • Intragonadal (ovary and testis).
    • Extragonadal (sacrococcygeal, retroperitoneum, mediastinum, and others).

References

  1. ↑ Zuquello RÁ, Tagliari G, Bagatini R, Camiña RH, Caron R, Lorencette NA; et al. (2016). “Immature teratoma presenting as a soft-tissue mass with no evidence of other sites of involvement: a case report”. Diagn Pathol. 11 (1): 76. doi:10.1186/s13000-016-0527-x. PMC 4986345. PMID 27528018.
  2. ↑ Peterson, Christine M.; Buckley, Celine; Holley, Susan; Menias, Christine O. (2012). “Teratomas: A Multimodality Review”. Current Problems in Diagnostic Radiology. 41 (6): 210–219. doi:10.1067/j.cpradiol.2012.02.001. ISSN 0363-0188.
  3. ↑ Meinhold-Heerlein I, Fotopoulou C, Harter P, Kurzeder C, Mustea A, Wimberger P; et al. (2016). “The new WHO classification of ovarian, fallopian tube, and primary peritoneal cancer and its clinical implications”. Arch Gynecol Obstet. 293 (4): 695–700. doi:10.1007/s00404-016-4035-8. PMID 26894303.
  4. ↑ Varma AV, Malpani G, Agrawal P, Malukani K, Dosi S (2017). “Clinicopathological spectrum of teratomas: An 8-year retrospective study from a tertiary care institute”. Indian J Cancer. 54 (3): 576–579. doi:10.4103/ijc.IJC_294_17. PMID 29798962.
Pathophysiology

Pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2]

Overview

The histopathology of teratoma depends on the histological subtype.Teratoma is a germ cell tumor due to abnormal development of pluripotent cells and renmant of primitive node.

Pathophysiology

 
 
 
 
 
 
 
Germ cell
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pathogenesis
 
 
 
 
 
 
 
Malignant transformation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mature teratoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
{{{ }}}
 
Tumors with primitive embryonic ectoderm, mesoderm, and/or endoderm differentiation{{{ }}}
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
{{{ }}}
 
 
 
 
 
 
 
 
 
 
 
Immature teratoma
 

Pathogenesis

  • Mature teratoma arises from a pathological transformation of primordial germ cell during the develompment.[1][2]
  • Mature teratoma comes from a single germ cell tumor after first phase of meiosis and failure of meiosis type II.[3][4][5]
  • Mature teratoma contains a well differentiated tumor with all three germ layers (ectoderm, mesoderm and endoderm).[2]
  • Mature teratoma may be located in the embryonic fusion midline or paraxial, mediastinum, ovary, retroperitoneum, and sacrococcygeal.[6]
  • Immature teratoma may be due to the malignant tranformation of primitive germ cell layers and renmant of primive node.[7][8]

Genetics

Genes involved in the pathogenesis of teratoma include:[9]

  • Gain of part or all chromosomes
    • 1p
    • 16p
    • 19
    • 22q

Immunohistochemistry

  • Neuronal element found in mature or immature teratoma are positive for:[10][11]
  • Carcinoid tumor found in the monodermal teratoma may be positive for:[12]
    • Serotonin and peptides hormones.

Associated conditions

Conditions associated with teratoma include:

Gross and microscopy pathology

The gross and microscopy features of teratoma are described below:[16][12][17][7][18][19][20][21][22][23][24]

Types Gross pathology Microscopic pathology Images
Mature teratoma
  • Unilateral cystic mass in most cases, rarely solid
  • Predominantly cystic with hair tufts, teeth, and cartilaginous material
  • Unilocular in most cases
  • Capsular compoment is well defined
  • Soft, tan, measured about 3 to 21 cm in diameter
  • Contains three embryonic layers (misoderm, endoderm, and ectoderm)
  • Keratinized squamous cells epithelium
  • Adnexal structures (sebaceous glands, hair follicles)
  • Adipose tissues
  • Lobules of mature cartilage
  • Glands lined by the respiratry mucosa and digestive mucosa
  • Skeletal muscles
  • No cytology atypia
Immature teratoma
  • Solid mass with necrotic and hemorrhagic areas
  • Cystic cavities may be filled with serous or mucinous fluid
  • Capsular is not well defined
  • Tends to be larger than mature cystic teratoma
  • Neural tissues with neuroepithelial rosettes
  • Choroid plexus
  • Immature mesenchymal
  • Presence of primtive elements
  • Cytology atypia
Monodermal teratoma
  • Unilateral mass
  • Well differentiated neoplasm




    References

    1. ↑ Vural, F.; Vural, B.; Paksoy, N. (2015). “Vaginal teratoma: A case report and review of the literature”. Journal of Obstetrics and Gynaecology. 35 (7): 757–758. doi:10.3109/01443615.2015.1004525. ISSN 0144-3615.
    2. ↑ 2.0 2.1 El-Maarri, Osman; Rijlaarsdam, Martin A.; Tax, David M. J.; Gillis, Ad J. M.; Dorssers, Lambert C. J.; Koestler, Devin C.; de Ridder, Jeroen; Looijenga, Leendert H. J. (2015). “Genome Wide DNA Methylation Profiles Provide Clues to the Origin and Pathogenesis of Germ Cell Tumors”. PLOS ONE. 10 (4): e0122146. doi:10.1371/journal.pone.0122146. ISSN 1932-6203.
    3. ↑ Linder, David; McCaw, Barbara Kaiser; Hecht, Frederick (1975). “Parthenogenic Origin of Benign Ovarian Teratomas”. New England Journal of Medicine. 292 (2): 63–66. doi:10.1056/NEJM197501092920202. ISSN 0028-4793.
    4. ↑ Surti U, Hoffner L, Chakravarti A, Ferrell RE (1990). “Genetics and biology of human ovarian teratomas. I. Cytogenetic analysis and mechanism of origin”. Am J Hum Genet. 47 (4): 635–43. PMC 1683780. PMID 2220805.
    5. ↑ Caspi B, Lerner-Geva L, Dahan M, Chetrit A, Modan B, Hagay Z; et al. (2003). “A possible genetic factor in the pathogenesis of ovarian dermoid cysts”. Gynecol Obstet Invest. 56 (4): 203–6. doi:10.1159/000074755. PMID 14614249.
    6. ↑ Comerci JT, Licciardi F, Bergh PA, Gregori C, Breen JL (1994). “Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature”. Obstet Gynecol. 84 (1): 22–8. PMID 8008317.
    7. ↑ 7.0 7.1 Varma AV, Malpani G, Agrawal P, Malukani K, Dosi S (2017). “Clinicopathological spectrum of teratomas: An 8-year retrospective study from a tertiary care institute”. Indian J Cancer. 54 (3): 576–579. doi:10.4103/ijc.IJC_294_17. PMID 29798962.
    8. ↑ Keene DJ, Craigie RJ, Shabani A, Batra G, Hennayake S (2011). “Bipartite anterior extraperitoneal teratoma: evidence for the embryological origins of teratomas?”. Case Rep Med. 2011: 208940. doi:10.1155/2011/208940. PMC 3163403. PMID 21949666.
    9. ↑ Kraggerud SM, Szymanska J, Abeler VM, Kaern J, Eknaes M, Heim S et al. (2000) DNA copy number changes in malignant ovarian germ cell tumors. Cancer Res 60 (11):3025-30. PMID: 10850452
    10. ↑ Yoshikata R, Yamamoto T, Kobayashi M, Ota H (2006). “Immunohistochemical characteristics of mature ovarian cystic teratomas in patients with postoperative recurrence”. Int J Gynecol Pathol. 25 (1): 95–100. doi:10.1097/01.pgp.0000172082.17805.6c. PMID 16306792.
    11. ↑ Takayama, Yoshiyasu; Matsumura, Nozomi; Nobusawa, Sumihito; Ikota, Hayato; Minegishi, Takashi; Yokoo, Hideaki (2015). “Immunophenotypic features of immaturity of neural elements in ovarian teratoma”. Virchows Archiv. 468 (3): 337–343. doi:10.1007/s00428-015-1891-8. ISSN 0945-6317.
    12. ↑ 12.0 12.1 Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). “Ovarian Teratomas: Tumor Types and Imaging Characteristics”. RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.
    13. ↑ Liang Z, Yang S, Sun X, Li B, Li W, Liu Z et al. (2017) Teratoma-associated anti-NMDAR encephalitis: Two cases report and literature review. Medicine (Baltimore) 96 (49):e9177. DOI:10.1097/MD.0000000000009177 PMID: 29245365
    14. ↑ Dalmau, Josep; Gleichman, Amy J; Hughes, Ethan G; Rossi, Jeffrey E; Peng, Xiaoyu; Lai, Meizan; Dessain, Scott K; Rosenfeld, Myrna R; Balice-Gordon, Rita; Lynch, David R (2008). “Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies”. The Lancet Neurology. 7 (12): 1091–1098. doi:10.1016/S1474-4422(08)70224-2. ISSN 1474-4422.
    15. ↑ Malayev, Yuliya; Alberts, Jared; Verardi, Mary Ann; Mattison, Anissa R.; Imlay, Sherwin (2015). “Immature Teratoma Associated With Anti–N-Methyl-D-Aspartate Receptor Encephalitis”. The Journal of the American Osteopathic Association. 115 (9): 573. doi:10.7556/jaoa.2015.116. ISSN 0098-6151.
    16. ↑ Yayla Abide, Çiğdem; Bostancı Ergen, Evrim (2018). “Retrospective analysis of mature cystic teratomas in a single center and review of the literature”. Journal of Turkish Society of Obstetric and Gynecology. 15 (2): 95–98. doi:10.4274/tjod.86244. ISSN 1307-699X.
    17. ↑ Ulbright, Thomas M (2005). “Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues”. Modern Pathology. 18 (S2): S61–S79. doi:10.1038/modpathol.3800310. ISSN 0893-3952.
    18. ↑ Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST (2002). “CT and MR imaging of ovarian tumors with emphasis on differential diagnosis”. Radiographics. 22 (6): 1305–25. doi:10.1148/rg.226025033. PMID 12432104.
    19. ↑ da Silva TK, Ribeiro GJ, Scortegagna FA, Zanetti G, Marchiori E (2015). “Teratoma: a set of teeth in the pelvis”. Radiol Bras. 48 (4): 263–4. doi:10.1590/0100-3984.2015.0034. PMC 4567366. PMID 26379326.
    20. ↑ Rathore R, Sharma S, Agarwal S (2018). “Malignant transformation in mature cystic teratoma of the ovary: a retrospective study of eight cases and review of literature”. Prz Menopauzalny. 17 (2): 63–68. doi:10.5114/pm.2018.77304. PMC 6107092. PMID 30150913.
    21. ↑ Caruso PA, Marsh MR, Minkowitz S, Karten G (1971). “An intense clinicopathologic study of 305 teratomas of the ovary”. Cancer. 27 (2): 343–8. doi:10.1002/1097-0142(197102)27:2<343::aid-cncr2820270215>3.0.co;2-b. PMID 5100397.
    22. ↑ Wisniewski M, Deppisch LM (1973). “Solid teratomas of the ovary”. Cancer. 32 (2): 440–6. doi:10.1002/1097-0142(197308)32:2<440::aid-cncr2820320222>3.0.co;2-8. PMID 4722922.
    23. ↑ Moran CA, Suster S (1997). “Primary germ cell tumors of the mediastinum: I. Analysis of 322 cases with special emphasis on teratomatous lesions and a proposal for histopathologic classification and clinical staging”. Cancer. 80 (4): 681–90. PMID 9264351.
    24. ↑ Kao CS, Bangs CD, Aldrete G, Cherry AM, Ulbright TM (2018). “A Clinicopathologic and Molecular Analysis of 34 Mediastinal Germ Cell Tumors Suggesting Different Modes of Teratoma Development”. Am J Surg Pathol. 42 (12): 1662–1673. doi:10.1097/PAS.0000000000001164. PMID 30256256.

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    Causes

    Causes

    Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2]

    Overview

    There are no established causes for teratoma. However, there are certain risk factors that predispose to increased risk of teratoma.

    Causes

    There are no established causes for teratoma. However, there are certain risk factors that predispose to increased risk of teratoma

    References

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    Differentiating Teratoma from other Diseases

    Differentiating Teratoma from other Diseases

    Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2]

    Overview

    Differentiating teratoma cancer from other diseases on the basis of age of onset, vaginal discharge and constitutional symptoms

    On the basis of age of onset, vaginal discharge, and constitutional symptoms, teratoma must be differentiated from tubo-ovarian abscess, ectopic pregnancy, hydrosalpinx, salpingitis, fallopian tube carcinoma, uterine leiomyoma, choriocarcinoma, leiomyosarcoma, pregnancy, appendiceal abscess, appendiceal neoplasm, diverticular abscess, colorectal cancer, pelvic kidney, advanced bladder cancer, and retroperitoneal sarcoma.[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81]

    Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
    Age of onset Symptoms Physical examination
    Lab Findings Imaging Immunohistopathology
    Pelvic/abdominal pain or pressure Vaginal bleeding/discharge GI dysturbance Fever Tenderness CT scan/US MRI
    Gynecologic
    Ovarian Follicular cysts
    [1]     		+/– – – – +/–
    • In US we may see a >3 cm simple cyst with no internal echo and with posterior acoustic enhancement
    • NA
    Theca lutein cysts
    [2][3][4]     		+/– – – – +/–
    Serous cystadenoma/carcinoma
    [5][6][7][8]
    • >55 y/o
    		 +/– – – – +/–
    • In US we may see simple or multiloculated cyst
    • In serous cystadenocarcinoma we may see papillary projection inside the cyst
    • In serous cystadenocarcinoma we may see ascites
    • We may see a simple cyst with beak sign, hypointense on T1 and hyperintense on T2
    • We may see some Solid malignant components inside the cyst with intermediate signal on T1 and T2
    Mucinous cystadenoma/carcinoma
    [9][10][11]
    • >55 y/o
    		 +/– – – – +/–
    • Stained glass appearance due to variable signal intensity on T1 and T2
    • The more mucin we have, there is more intensity on T1
    • and less intensity on T2
    Endometrioma
    [12][13][14]     		+ + +/– – +
    • hyperintensity on T1-weighted images and a hypointensity on T2-weighted images
    • Powder burn hemorrhages
    Teratoma
    [15][16][17][18]
    • 10-30 y/o
    		 +/– – – – +/–
    • We may see evidence of fat components
    Dysgerminoma
    [19][20]
    • in the second to third decade of life
    		 + +/– – – +/–
    • We may see ovarian mass with septation which are hyperintense on T1 and hypo or isointense on T2 imaging
    • Sheets fried egg appearance cells
    Yolk sac tumor
    [21][22][23]     		+ – – – +
    • High levels of AFP
    • In US we may see a combination of echogenic and hypoechoic components
    • Yellow appearance
    • Schiller-Duval bodies (glomeruli like structures)
    Fibroma
    [24][25][26]
    • >50 y/o
    • Pulling sensation in the groin
    		 – – – +/–
    • In CT scan we may see a unilateral mass with poor contrast enhancement
    • Low signal intensity on T1 and T2
    Thecoma
    [27][28][29]
    • >50 y/o
    		 +/– – – –
    Granulosa cell tumor
    [30][31][32][33]
    • 50-60 y/o
    		 + +/– – –
    Sertoli-leydig cell tumor
    [34][35]
    • 15 to 35 y/o
    		 +/– – – – –
    • In US we may see unilateral Well-defined hypoechoic lesion
    • Low T2 signal intensity
    • areas of high signal intensity
    Brenner tumor
    [36][37]
    • >55 y/o
    		 +/– – – – – –
    • Hypointense on T2 because of fibrous content
    • Most of the times it’s an accidental finding
    Krukenberg tumor
    [38][39]
    • >55 y/o
    		 +/– – +/–

    Based on underlying malignancy

    		– –
    Tubal tubo-ovarian abscess
    [40][41][42][43]     		+ + – + +
    • hypointense in T1 and heterogeneous in T2
    Ectopic pregnancy
    [44]     		+ + +/– – +
    • NA
    • NA
    Hydrosalpinx
    [45][46][47]
    • NA
    		 + – – – +/– –
    • NA
    Salpingitis
    [48]     		+ + – + +
    • In US we may see , edematous and thickened endosalpingeal folds
    • NA
    • NA
    Fallopian tube carcinoma
    [49]
    • >60 y/o
    		 + + + – +/–
    • Low signal on T1
    • In case of hemorrhage inside the tumor we may see high signal intensity on T1
    • Low or of intermediate signal on T2
    • Based on the tumor type we may have different biopsy finding
    Uterine Leiomyoma
    [50][51]     		+ + – – +/–
    • Low to intermediate signal intensity on T1 and T2
    • In case of necrosis inside the mass, there might be some high signal lesions on T2
    Choriocarcinoma
    [52][53][54][55]     		+ + +/– – +
    • We may see an infiltrative uterine mass and thickening of uterine wall
    Leiomyosarcoma
    [56][57][58][59][60]
    • >55 y/o
    		 + + – – +/–
    • Increased uterine size
    • Irregular central zones of low signal intensity (tumor necrosis)
    Pregnancy
    [61]     		+/− +/− +/− – –
    • NA
    Non-gynecologic
    GIT Appendiceal abscess
    [62]
    • NA
    		 + – + +/– +
    • NA
    Appendiceal neoplasm
    [63][64][65][66][67]     		+ – + – +/–
    • Soft tissue mass in the appendix
    • We may see invasion to other structures
    • Gray/yellowi color
    • Cystic structures with angiolymphatic invasion
      Diverticular abscess
      [72]
      • >50 y/o
      		 + – + +/– +
      • Ill-defined lesion with air and fluid inside
      • Adjacent bowel loop wall thickening
      • Smudged mesenteric fat
      • We may see a lesion with air and fluid inside
      • NA
      Colorectal cancer
      [68][69][70][71]
      • >50 y/o
      		 + – + – +/–
      • We may see tumor mass and the extension of tumor to other structures
      Renal

      Bladder

      		Pelvic kidney
      [73][74]
      • NA
      		 −/+

      In case of sever hydronephrosis or renal stone we may have pelvic pain

      		– − − − −
      • We may see normal kidney structure
      • NA
      • It may cause tract infection (UTI), obstruction, and renal calculi.
      • It may be associated with RCC
      Bladder cancer
      [75][76][77]
      • ≥65 y/o
      		 + – – – –
      • isointense compared to muscle in T1
      • slightly hyperintense compared to muscle in T2
      Others Retroperitoneal sarcoma
      [78][79][80][81]
      • 40-50 y/o
      		 + – + − −

      ABBREVIATIONS

      BTA=Bladder tumor associated antigen, NMP= Nuclear matrix proteins, CEA= Carcinoembryonic antigen, US= Ultrasound, HCG= Human chorionic gonadotropin, LDH= Lactate dehydrogenase, AFP= Alpha fitoprotein, CA125= Cancer antigen 125, H&E= Hematoxylin and eosin, MRI= Magnetic resonance imaging, GI= Gastrointestinal tract, PID= Pelvic inflammatory disease, CA19-9= Carbohydrate antigen 19-9, 5HIAA= 5-hydroxyindoleacetic acid, MEN syndrome= Multiple endocrine neoplasia syndrome, HNPCC= Hereditary nonpolyposis colorectal cancer, UTI= Urinary tract infection, RCC= Renal cell carcinoma


      References

      1. ↑ 1.0 1.1 Levine D, Brown DL, Andreotti RF, Benacerraf B, Benson CB, Brewster WR, Coleman B, Depriest P, Doubilet PM, Goldstein SR, Hamper UM, Hecht JL, Horrow M, Hur HC, Marnach M, Patel MD, Platt LD, Puscheck E, Smith-Bindman R (September 2010). “Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound Consensus Conference Statement”. Radiology. 256 (3): 943–54. doi:10.1148/radiol.10100213. PMID 20505067.
      2. ↑ 2.0 2.1 Montz FJ, Schlaerth JB, Morrow CP (August 1988). “The natural history of theca lutein cysts”. Obstet Gynecol. 72 (2): 247–51. PMID 2455880.
      3. ↑ 3.0 3.1 Southam, Anna L. (1962). “Massive Ovarian Hyperstimulation with Clomiphene Citrate”. JAMA: The Journal of the American Medical Association. 181 (5): 443. doi:10.1001/jama.1962.03050310083018b. ISSN 0098-7484.
      4. ↑ 4.0 4.1 Nguyen, K T; Reid, R L; Sauerbrei, E (1986). “Antenatal sonographic detection of a fetal theca lutein cyst: a clue to maternal diabetes mellitus”. Journal of Ultrasound in Medicine. 5 (11): 665–667. doi:10.7863/jum.1986.5.11.665. ISSN 0278-4297.
      5. ↑ 5.0 5.1 Jung, Seung Eun; Lee, Jae Mun; Rha, Sung Eun; Byun, Jae Young; Jung, Jung Im; Hahn, Seong Tai (2002). “CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis”. RadioGraphics. 22 (6): 1305–1325. doi:10.1148/rg.226025033. ISSN 0271-5333.
      6. ↑ 6.0 6.1 Imai, Shunsuke; Kiyozuka, Yasuhiko; Maeda, Hiroko; Noda, Tuneo; Hosick, Howard L. (1990). “Establishment and Characterization of a Human Ovarian Serous Cystadenocarcinoma Cell Line That Produces the Tumor Markers CA-125 and Tissue Polypeptide Antigen”. Oncology. 47 (2): 177–184. doi:10.1159/000226813. ISSN 0030-2414.
      7. ↑ 7.0 7.1 Malpica A, Deavers MT, Lu K, Bodurka DC, Atkinson EN, Gershenson DM, Silva EG (April 2004). “Grading ovarian serous carcinoma using a two-tier system”. Am. J. Surg. Pathol. 28 (4): 496–504. PMID 15087669.
      8. ↑ 8.0 8.1 Li J, Fadare O, Xiang L, Kong B, Zheng W (March 2012). “Ovarian serous carcinoma: recent concepts on its origin and carcinogenesis”. J Hematol Oncol. 5: 8. doi:10.1186/1756-8722-5-8. PMID 22405464.
      9. ↑ 9.0 9.1 Hoerl HD, Hart WR (December 1998). “Primary ovarian mucinous cystadenocarcinomas: a clinicopathologic study of 49 cases with long-term follow-up”. Am. J. Surg. Pathol. 22 (12): 1449–62. PMID 9850171.
      10. ↑ 10.0 10.1 Lee KR, Scully RE (November 2000). “Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with ‘pseudomyxoma peritonei‘“. Am. J. Surg. Pathol. 24 (11): 1447–64. PMID 11075847.
      11. ↑ 11.0 11.1 Jung, Seung Eun; Lee, Jae Mun; Rha, Sung Eun; Byun, Jae Young; Jung, Jung Im; Hahn, Seong Tai (2002). “CT and MR Imaging of Ovarian Tumors with Emphasis on Differential Diagnosis”. RadioGraphics. 22 (6): 1305–1325. doi:10.1148/rg.226025033. ISSN 0271-5333.
      12. ↑ 12.0 12.1 Mol BW, Bayram N, Lijmer JG, Wiegerinck MA, Bongers MY, van der Veen F, Bossuyt PM (December 1998). “The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis”. Fertil. Steril. 70 (6): 1101–8. PMID 9848302.
      13. ↑ 13.0 13.1 Kinkel, Karen; Frei, Kathrin A.; Balleyguier, Corinne; Chapron, Charles (2005). “Diagnosis of endometriosis with imaging: a review”. European Radiology. 16 (2): 285–298. doi:10.1007/s00330-005-2882-y. ISSN 0938-7994.
      14. ↑ 14.0 14.1 de Ziegler, Dominique; Borghese, Bruno; Chapron, Charles (2010). “Endometriosis and infertility: pathophysiology and management”. The Lancet. 376 (9742): 730–738. doi:10.1016/S0140-6736(10)60490-4. ISSN 0140-6736.
      15. ↑ 15.0 15.1 Kawai, Michiyasu; Kano, Takeo; Kikkawa, Fumitaka; Morikawa, Yoshimitsu; Oguchi, Hidenori; Nakashima, Nobuo; Ishizuka, Takao; Kuzuya, Kazuo; Ohta, Masahiro; Arii, Yoshitaro; Tomoda, Yutaka (1992). “Seven tumor markers in benign and malignant germ cell tumors of the ovary”. Gynecologic Oncology. 45 (3): 248–253. doi:10.1016/0090-8258(92)90299-X. ISSN 0090-8258.
      16. ↑ 16.0 16.1 Dunzendorfer, Thomas; deLAS MORENAS, ANTONIO; Kalir, Tamara; Levin, Robert M. (1999). “Struma Ovarii and Hyperthyroidism”. Thyroid. 9 (5): 499–502. doi:10.1089/thy.1999.9.499. ISSN 1050-7256.
      17. ↑ 17.0 17.1 Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). “Ovarian Teratomas: Tumor Types and Imaging Characteristics”. RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.
      18. ↑ 18.0 18.1 Saba, Luca; Guerriero, Stefano; Sulcis, Rosa; Virgilio, Bruna; Melis, GianBenedetto; Mallarini, Giorgio (2009). “Mature and immature ovarian teratomas: CT, US and MR imaging characteristics”. European Journal of Radiology. 72 (3): 454–463. doi:10.1016/j.ejrad.2008.07.044. ISSN 0720-048X.
      19. ↑ 19.0 19.1 Dgani, R.; Shoham(Schwartz), Z.; Czernobilsky, B.; Kaftori, A.; Borenstein, R.; Lancet, M. (1988). “Lactic dehydrogenase, alkaline phosphatase and human chorionic gonadotropin in a pure ovarian dysgerminoma”. Gynecologic Oncology. 30 (1): 44–50. doi:10.1016/0090-8258(88)90044-3. ISSN 0090-8258.
      20. ↑ 20.0 20.1 Tanaka YO, Kurosaki Y, Nishida M, Michishita N, Kuramoto K, Itai Y, Kubo T (1994). “Ovarian dysgerminoma: MR and CT appearance”. J Comput Assist Tomogr. 18 (3): 443–8. PMID 8188914.
      21. ↑ 21.0 21.1 Yang, Grace C.H. (2000). “Fine-needle aspiration cytology of Schiller-Duval bodies of yolk-sac tumor”. Diagnostic Cytopathology. 23 (4): 228–232. doi:10.1002/1097-0339(200010)23:4<228::AID-DC2>3.0.CO;2-M. ISSN 8755-1039.
      22. ↑ 22.0 22.1 Levitin, A; Haller, K D; Cohen, H L; Zinn, D L; O’Connor, M T (1996). “Endodermal sinus tumor of the ovary: imaging evaluation”. American Journal of Roentgenology. 167 (3): 791–793. doi:10.2214/ajr.167.3.8751702. ISSN 0361-803X.
      23. ↑ 23.0 23.1 Talerman, A.; Haije, W. G. (1974). “Alpha-fetoprotein and germ cell tumors: A possible role of yolk sac tumor in production of alpha-fetoprotein”. Cancer. 34 (5): 1722–1726. doi:10.1002/1097-0142(197411)34:5<1722::AID-CNCR2820340521>3.0.CO;2-F. ISSN 0008-543X.
      24. ↑ 24.0 24.1 MEIGS JV (May 1954). “Fibroma of the ovary with ascites and hydrothorax; Meigs’ syndrome”. Am. J. Obstet. Gynecol. 67 (5): 962–85. PMID 13148256.
      25. ↑ 25.0 25.1 Sivanesaratnam, V.; Dutta, R.; Jayalakshmi, P. (1990). “Ovarian fibroma – clinical and histopathological characteristics”. International Journal of Gynecology & Obstetrics. 33 (3): 243–247. doi:10.1016/0020-7292(90)90009-A. ISSN 0020-7292.
      26. ↑ 26.0 26.1 Abad, Antonio; Cazorla, Eduardo; Ruiz, Fernando; Aznar, Ismael; Asins, Enrique; Llixiona, Joaquin (1999). “Meigs’ syndrome with elevated CA125: case report and review of the literature”. European Journal of Obstetrics & Gynecology and Reproductive Biology. 82 (1): 97–99. doi:10.1016/S0301-2115(98)00174-2. ISSN 0301-2115.
      27. ↑ 27.0 27.1 Yaghoobian, Jahanguir; Pinck, Robert L. (1983). “Ultrasound findings in thecoma of the ovary”. Journal of Clinical Ultrasound. 11 (2): 91–93. doi:10.1002/jcu.1870110207. ISSN 0091-2751.
      28. ↑ 28.0 28.1 Li, Xinchun; Zhang, Weidong; Zhu, Guangbin; Sun, Congpeng; Liu, Qingyu; Shen, Yuechun (2012). “Imaging Features and Pathologic Characteristics of Ovarian Thecoma”. Journal of Computer Assisted Tomography. 36 (1): 46–53. doi:10.1097/RCT.0b013e31823f6186. ISSN 0363-8715.
      29. ↑ 29.0 29.1 Proctor, Francis E.; Greeley, Joseph P.; Rathmell, Thomas K. (1951). “Malignant thecoma of the ovary”. American Journal of Obstetrics and Gynecology. 62 (1): 185–192. doi:10.1016/0002-9378(51)91109-X. ISSN 0002-9378.
      30. ↑ 30.0 30.1 Pectasides D, Pectasides E, Psyrri A (February 2008). “Granulosa cell tumor of the ovary”. Cancer Treat. Rev. 34 (1): 1–12. doi:10.1016/j.ctrv.2007.08.007. PMID 17945423.
      31. ↑ 31.0 31.1 Stenwig, Jan Trygve; Hazekamp, Johan The.; Beecham, Jackson B. (1979). “Granulosa cell tumors of the ovary. A clinicopathological study of 118 cases with long-term follow-up”. Gynecologic Oncology. 7 (2): 136–152. doi:10.1016/0090-8258(79)90090-8. ISSN 0090-8258.
      32. ↑ 32.0 32.1 Morikawa K, Hatabu H, Togashi K, Kataoka ML, Mori T, Konishi J (1997). “Granulosa cell tumor of the ovary: MR findings”. J Comput Assist Tomogr. 21 (6): 1001–4. PMID 9386298.
      33. ↑ 33.0 33.1 Ko SF, Wan YL, Ng SH, Lee TY, Lin JW, Chen WJ, Kung FT, Tsai CC (May 1999). “Adult ovarian granulosa cell tumors: spectrum of sonographic and CT findings with pathologic correlation”. AJR Am J Roentgenol. 172 (5): 1227–33. doi:10.2214/ajr.172.5.10227493. PMID 10227493.
      34. ↑ 34.0 34.1 Lantzsch, T.; Stoerer, S.; Lawrenz, K.; Buchmann, J.; Strauss, H.-G.; Koelbl, H. (2001). “Sertoli-Leydig cell tumor”. Archives of Gynecology and Obstetrics. 264 (4): 206–208. doi:10.1007/s004040000114. ISSN 0932-0067.
      35. ↑ 35.0 35.1 Jung, Seung Eun; Rha, Sung Eun; Lee, Jae Mun; Park, Soo Youn; Oh, Soon Nam; Cho, Kyoung Sik; Lee, Eun Ju; Byun, Jae Young; Hahn, Seong Tai (2005). “CT and MRI Findings of Sex Cord–Stromal Tumor of the Ovary”. American Journal of Roentgenology. 185 (1): 207–215. doi:10.2214/ajr.185.1.01850207. ISSN 0361-803X.
      36. ↑ 36.0 36.1 Shevchuk, Maria M.; Fenoglio, Cecilia M.; Richart, Ralph M. (1980). “Histogenesis of brenner tumors, I: Histology and ultrastructure”. Cancer. 46 (12): 2607–2616. doi:10.1002/1097-0142(19801215)46:12<2607::AID-CNCR2820461213>3.0.CO;2-Q. ISSN 0008-543X.
      37. ↑ 37.0 37.1 Outwater, Eric K; Siegelman, Evan S; Kim, Bohyun; Chiowanich, Peerapod; Blasbalg, Roberto; Kilger, Alex (1998). “Ovarian Brenner tumors: MR imaging characteristics”. Magnetic Resonance Imaging. 16 (10): 1147–1153. doi:10.1016/S0730-725X(98)00136-2. ISSN 0730-725X.
      38. ↑ 38.0 38.1 Kim SH, Kim WH, Park KJ, Lee JK, Kim JS (1996). “CT and MR findings of Krukenberg tumors: comparison with primary ovarian tumors”. J Comput Assist Tomogr. 20 (3): 393–8. PMID 8626898.
      39. ↑ 39.0 39.1 Al-Agha OM, Nicastri AD (November 2006). “An in-depth look at Krukenberg tumor: an overview”. Arch. Pathol. Lab. Med. 130 (11): 1725–30. doi:10.1043/1543-2165(2006)130[1725:AILAKT]2.0.CO;2. PMID 17076540.
      40. ↑ 40.0 40.1 Landers, D. V.; Sweet, R. L. (1983). “Tubo-ovarian Abscess: Contemporary Approach to Management”. Clinical Infectious Diseases. 5 (5): 876–884. doi:10.1093/clinids/5.5.876. ISSN 1058-4838.
      41. ↑ 41.0 41.1 Stewart Taylor, E.; McMillan, James H.; Greer, Benjamin E.; Droegemueller, William; Thompson, Horace E. (1975). “The intrauterine device and tubo-ovarian abscess”. American Journal of Obstetrics and Gynecology. 123 (4): 338–348. doi:10.1016/S0002-9378(16)33434-2. ISSN 0002-9378.
      42. ↑ 42.0 42.1 Ha, H. K.; Lim, G. Y.; Cha, E. S.; Lee, H. G.; Ro, H. J.; Kim, H. S.; Kim, H. H.; Joo, S. W.; Jee, M. K. (1995). “MR Imaging of Tubo-Ovarian Abscess”. Acta Radiologica. 36 (5): 510–514. doi:10.1080/02841859509173418. ISSN 0284-1851.
      43. ↑ 43.0 43.1 Varras M, Polyzos D, Perouli E, Noti P, Pantazis I, Akrivis C (2003). “Tubo-ovarian abscesses: spectrum of sonographic findings with surgical and pathological correlations”. Clin Exp Obstet Gynecol. 30 (2–3): 117–21. PMID 12854857. Vancouver style error: initials (help)
      44. ↑ 44.0 44.1 Barnhart, Kurt T. (2009). “Ectopic Pregnancy”. New England Journal of Medicine. 361 (4): 379–387. doi:10.1056/NEJMcp0810384. ISSN 0028-4793.
      45. ↑ 45.0 45.1 Kim, Mi Young; Rha, Sung Eun; Oh, Soon Nam; Jung, Seung Eun; Lee, Young Joon; Kim, You Sung; Byun, Jae Young; Lee, Ahwon; Kim, Mee-Ran (2009). “MR Imaging Findings of Hydrosalpinx: A Comprehensive Review”. RadioGraphics. 29 (2): 495–507. doi:10.1148/rg.292085070. ISSN 0271-5333.
      46. ↑ 46.0 46.1 Atri M, Nazarnia S, Bret PM, Aldis AE, Kintzen G, Reinhold C (July 1994). “Endovaginal sonographic appearance of benign ovarian masses”. Radiographics. 14 (4): 747–60, discussion 761–2. doi:10.1148/radiographics.14.4.7938766. PMID 7938766.
      47. ↑ 47.0 47.1 Chanelles, Olivier; Ducarme, Guillaume; Sifer, Christophe; Hugues, Jean-Noel; Touboul, Cyril; Poncelet, Christophe (2011). “Hydrosalpinx and infertility: what about conservative surgical management?”. European Journal of Obstetrics & Gynecology and Reproductive Biology. 159 (1): 122–126. doi:10.1016/j.ejogrb.2011.07.004. ISSN 0301-2115.
      48. ↑ 48.0 48.1 Czerwenka K, Heuss F, Hosmann J, Manavi M, Jelincic D, Kubista E (October 1994). “Salpingitis caused by Chlamydia trachomatis and its significance for infertility”. Acta Obstet Gynecol Scand. 73 (9): 711–5. PMID 7976247.
      49. ↑ 49.0 49.1 Niloff, Jonathan M.; Klug, Thomas L.; Schaetzl, Elena; Zurawski, Vincent R.; Knapp, Robert C.; Bast, Robert C. (1984). “Elevation of serum CA125 in carcinomas of the fallopian tube, endometrium, and endocervix”. American Journal of Obstetrics and Gynecology. 148 (8): 1057–1058. doi:10.1016/S0002-9378(84)90444-7. ISSN 0002-9378.
      50. ↑ 50.0 50.1 Bulletti, Carlo; De Ziegler, Dominique; Polli, Valeria; Flamigni, Carlo (1999). “The role of leiomyomas in infertility”. The Journal of the American Association of Gynecologic Laparoscopists. 6 (4): 441–445. doi:10.1016/S1074-3804(99)80008-5. ISSN 1074-3804.
      51. ↑ 51.0 51.1 Murase, Eiko; Siegelman, Evan S.; Outwater, Eric K.; Perez-Jaffe, Liza A.; Tureck, Richard W. (1999). “Uterine Leiomyomas: Histopathologic Features, MR Imaging Findings, Differential Diagnosis, and Treatment”. RadioGraphics. 19 (5): 1179–1197. doi:10.1148/radiographics.19.5.g99se131179. ISSN 0271-5333.
      52. ↑ 52.0 52.1 Seckl, Michael J; Fisher, Rosemary A; Salerno, Giovanni; Rees, Helene; Paradinas, Fernando J; Foskett, Marianne; Newlands, Edward S (2000). “Choriocarcinoma and partial hydatidiform moles”. The Lancet. 356 (9223): 36–39. doi:10.1016/S0140-6736(00)02432-6. ISSN 0140-6736.
      53. ↑ 53.0 53.1 Nishikawa, Yoshiki; Kaseki, Shigeaki; Tomoda, Yutaka; Ishizuka, Takao; Asai, Yasumasa; Suzuki, Toshio; Ushijima, Hiroshi (1985). “Histopathologic classification of uterine choriocarcinoma”. Cancer. 55 (5): 1044–1051. doi:10.1002/1097-0142(19850301)55:5<1044::AID-CNCR2820550520>3.0.CO;2-7. ISSN 0008-543X.
      54. ↑ 54.0 54.1 Libshitz HI, Baber CE, Hammond CB (April 1977). “The pulmonary metastases of choriocarcinoma”. Obstet Gynecol. 49 (4): 412–6. PMID 558566.
      55. ↑ 55.0 55.1 Diouf A, Cissé ML, Laïco A, Ndiaye D, Moreau JC, Diadhiou F (May 2005). “[Sonographic features of gestational choriocarcinoma]”. J Radiol (in French). 86 (5 Pt 1): 469–73. PMID 16114202.
      56. ↑ 56.0 56.1 Seki, K.; Hoshihara, T.; Nagata, I. (1992). “Leiomyosarcoma of the Uterus: Ultrasonography and Serum Lactate Dehydrogenase Level”. Gynecologic and Obstetric Investigation. 33 (2): 114–118. doi:10.1159/000294861. ISSN 1423-002X.
      57. ↑ 57.0 57.1 Juang CM, Yen MS, Horng HC, Twu NF, Yu HC, Hsu WL (2006). “Potential role of preoperative serum CA125 for the differential diagnosis between uterine leiomyoma and uterine leiomyosarcoma”. Eur. J. Gynaecol. Oncol. 27 (4): 370–4. PMID 17009628.
      58. ↑ 58.0 58.1 Pattani, Sita J.; Kier, Ruben; Deal, Robert; Luchansky, Edward (1995). “MRI of uterine leiomyosarcoma”. Magnetic Resonance Imaging. 13 (2): 331–333. doi:10.1016/0730-725X(95)93813-5. ISSN 0730-725X.
      59. ↑ 59.0 59.1 McLeod, A J; Zornoza, J; Shirkhoda, A (1984). “Leiomyosarcoma: computed tomographic findings”. Radiology. 152 (1): 133–136. doi:10.1148/radiology.152.1.6729102. ISSN 0033-8419.
      60. ↑ 60.0 60.1 Robboy, Stanley J.; Bentley, Rex C.; Butnor, Kelly; Anderson, Malcolm C. (2000). “Pathology and Pathophysiology of Uterine Smooth-Muscle Tumors”. Environmental Health Perspectives. 108: 779. doi:10.2307/3454306. ISSN 0091-6765.
      61. ↑ 61.0 61.1 Cacctatore, Bruno; Tttttnen, Atla; Stenman, Ulf-Hakan; Ylostalo, Pekka (1990). “Normal early pregnancy: serum hCG levels and vaginal ultrasonography findings”. BJOG: An International Journal of Obstetrics and Gynaecology. 97 (10): 899–903. doi:10.1111/j.1471-0528.1990.tb02444.x. ISSN 1470-0328.
      62. ↑ 62.0 62.1 Pinto Leite N, Pereira JM, Cunha R, Pinto P, Sirlin C (August 2005). “CT evaluation of appendicitis and its complications: imaging techniques and key diagnostic findings”. AJR Am J Roentgenol. 185 (2): 406–17. doi:10.2214/ajr.185.2.01850406. PMID 16037513.
      63. ↑ 63.0 63.1 Chapter 5: Tumours of the Appendix – IARC. https://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb2/bb2-chap5.pdf Accessed on January 15, 2019
      64. ↑ 64.0 64.1 Goede, A. C.; Caplin, M. E.; Winslet, M. C. (2003). “Carcinoid tumour of the appendix”. British Journal of Surgery. 90 (11): 1317–1322. doi:10.1002/bjs.4375. ISSN 0007-1323.
      65. ↑ 65.0 65.1 Pablo Carmignani, C.; Hampton, Regina; E. Sugarbaker, Christina; Chang, David; H. Sugarbaker, Paul (2004). “Utility of CEA and CA 19-9 tumor markers in diagnosis and prognostic assessment of mucinous epithelial cancers of the appendix”. Journal of Surgical Oncology. 87 (4): 162–166. doi:10.1002/jso.20107. ISSN 0022-4790.
      66. ↑ 66.0 66.1 Limsui D, Vierkant RA, Tillmans LS, Wang AH, Weisenberger DJ, Laird PW, Lynch CF, Anderson KE, French AJ, Haile RW, Harnack LJ, Potter JD, Slager SL, Smyrk TC, Thibodeau SN, Cerhan JR, Limburg PJ (July 2010). “Cigarette smoking and colorectal cancer risk by molecularly defined subtypes”. J. Natl. Cancer Inst. 102 (14): 1012–22. doi:10.1093/jnci/djq201. PMC 2915616. PMID 20587792.
      67. ↑ 67.0 67.1 Duh QY, Hybarger CP, Geist R, Gamsu G, Goodman PC, Gooding GA, Clark OH (July 1987). “Carcinoids associated with multiple endocrine neoplasia syndromes”. Am. J. Surg. 154 (1): 142–8. PMID 2886072.
      68. ↑ 68.0 68.1 Zhu, Amy; Kaneshiro, Marc; Kaunitz, Jonathan D. (2010). “Evaluation and Treatment of Iron Deficiency Anemia: A Gastroenterological Perspective”. Digestive Diseases and Sciences. 55 (3): 548–559. doi:10.1007/s10620-009-1108-6. ISSN 0163-2116.
      69. ↑ 69.0 69.1 Macdonald JS (1999). “Carcinoembryonic antigen screening: pros and cons”. Semin Oncol. 26 (5): 556–60. PMID 10528904.
      70. ↑ 70.0 70.1 Haggar FA, Boushey RP (November 2009). “Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors”. Clin Colon Rectal Surg. 22 (4): 191–7. doi:10.1055/s-0029-1242458. PMC 2796096. PMID 21037809.
      71. ↑ 71.0 71.1 Taylor AJ, Youker JE (1991). “Imaging in colorectal carcinoma”. Semin Oncol. 18 (2): 99–110. PMID 2014406.
      72. ↑ 72.0 72.1 Hulnick, D H; Megibow, A J; Balthazar, E J; Naidich, D P; Bosniak, M A (1984). “Computed tomography in the evaluation of diverticulitis”. Radiology. 152 (2): 491–495. doi:10.1148/radiology.152.2.6739821. ISSN 0033-8419.
      73. ↑ 73.0 73.1 Weizer, Alon Z.; Springhart, W. Patrick; Ekeruo, Wesley O.; Matlaga, Brian R.; Tan, Yeh H.; Assimos, Dean G.; Preminger, Glenn M. (2005). “Ureteroscopic management of renal calculi in anomalous kidneys”. Urology. 65 (2): 265–269. doi:10.1016/j.urology.2004.09.055. ISSN 0090-4295.
      74. ↑ 74.0 74.1 Ross, Jonathan H.; Kay, Robert (1998). “URETEROPELVIC JUNCTION OBSTRUCTION IN ANOMALOUS KIDNEYS”. Urologic Clinics of North America. 25 (2): 219–225. doi:10.1016/S0094-0143(05)70010-0. ISSN 0094-0143.
      75. ↑ 75.0 75.1 Barentsz JO, Jager GJ, Witjes JA, Ruijs JH (1996). “Primary staging of urinary bladder carcinoma: the role of MRI and a comparison with CT”. Eur Radiol. 6 (2): 129–33. PMID 8797968.
      76. ↑ 76.0 76.1 Shariat SF, Karam JA, Lotan Y, Karakiewizc PI (2008). “Critical evaluation of urinary markers for bladder cancer detection and monitoring”. Rev Urol. 10 (2): 120–35. PMC 2483317. PMID 18660854.
      77. ↑ 77.0 77.1 Metts MC, Metts JC, Milito SJ, Thomas CR (June 2000). “Bladder cancer: a review of diagnosis and management”. J Natl Med Assoc. 92 (6): 285–94. PMC 2640522. PMID 10918764.
      78. ↑ 78.0 78.1 Storm FK, Mahvi DM (July 1991). “Diagnosis and management of retroperitoneal soft-tissue sarcoma”. Ann. Surg. 214 (1): 2–10. PMC 1358407. PMID 2064467.
      79. ↑ 79.0 79.1 Francis IR, Cohan RH, Varma DG, Sondak VK (August 2005). “Retroperitoneal sarcomas”. Cancer Imaging. 5: 89–94. doi:10.1102/1470-7330.2005.0019. PMID 16154826.
      80. ↑ 80.0 80.1 Silverstein, Murray N.; Wakim, Khalil G.; Bahn, Robert C. (1964). “Hypoglycemia associated with neoplasia”. The American Journal of Medicine. 36 (3): 415–423. doi:10.1016/0002-9343(64)90168-8. ISSN 0002-9343.
      81. ↑ 81.0 81.1 Storm FK, Mahvi DM (July 1991). “Diagnosis and management of retroperitoneal soft-tissue sarcoma”. Ann. Surg. 214 (1): 2–10. PMC 1358407. PMID 2064467.
      Epidemiology and Demographics

      Epidemiology and Demographics

      Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2]

      Overview

      Epidemiology and Demographics

      Incidence

      • The incidence of mature teratoma is approximately 1.2-14.2 cases per 100,000 individuals worldwide.[1]

      Prevalence

      • The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
      • The prevalence of [disease/malignancy] is estimated to be [number] cases annually.

      Case-fatality rate/Mortality rate

      • In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
      • The case-fatality rate/mortality rate of [disease name] is approximately [number range].

      Age

      • Immature is mostly seen in younger patients and postpubertal males.[2][3]
      • Mature teratoma commonly affects aldolescent, but it occurs in all age groups.[2]

      Race

      • There is no racial predilection to [disease name].
      • [Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].

      Gender

      • [Disease name] affects men and women equally.
      • [Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.

      Region

      • The majority of [disease name] cases are reported in [geographical region].
      • [Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].

      Developed Countries

      Developing Countries

      References

      1. ↑ Westhoff C, Pike M, Vessey M (1988). “Benign ovarian teratomas: a population-based case-control study”. Br J Cancer. 58 (1): 93–8. doi:10.1038/bjc.1988.171. PMC 2246492. PMID 3166898.
      2. ↑ 2.0 2.1 Kao CS, Bangs CD, Aldrete G, Cherry AM, Ulbright TM (2018). “A Clinicopathologic and Molecular Analysis of 34 Mediastinal Germ Cell Tumors Suggesting Different Modes of Teratoma Development”. Am J Surg Pathol. 42 (12): 1662–1673. doi:10.1097/PAS.0000000000001164. PMID 30256256.
      3. ↑ Outwater, Eric K.; Siegelman, Evan S.; Hunt, Jennifer L. (2001). “Ovarian Teratomas: Tumor Types and Imaging Characteristics”. RadioGraphics. 21 (2): 475–490. doi:10.1148/radiographics.21.2.g01mr09475. ISSN 0271-5333.

      Template:WH Template:WS

      Risk Factors

      Risk Factors

      Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

      Overview

      There are no established risk factors for [disease name].

      OR

      The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].

      OR

      Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

      OR

      Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.

      Risk Factors

      There are no established risk factors for [disease name].

      OR

      The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].

      OR

      Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

      Common Risk Factors

      • Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
      • Common risk factors in the development of [disease name] include:
        • [Risk factor 1]
        • [Risk factor 2]
        • [Risk factor 3]

      Less Common Risk Factors

      • Less common risk factors in the development of [disease name] include:
        • [Risk factor 1]
        • [Risk factor 2]
        • [Risk factor 3]

      References

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      Screening

      Screening

      Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2]

      Overview

      There is insufficient evidence to recommend routine screening for teratoma.

      Screening

      There is insufficient evidence to recommend routine screening for Teratoma.

      References

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      Natural History, Complications and Prognosis

      Natural History, Complications and Prognosis

      Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2]

      Overview

      The prognosis of teratoma depends on the type of tumor and malignant transformation. Mature teratoma is begnin and has an excellent prognosis compared to immature teratoma which has a favorable prognosis.The 6 year survival rate of patients with mature teratoma is approximately 96%. The overall 5 years survival rate of patient with immature teratoma is 90% and 75% for stage II-IV.Common complications are malignant transformation, rupture, torsion, and hemolytic anemia.

      Natural History, Complications, and Prognosis

      Natural History

      • The symptoms of teratoma depends on the locations of the tumors.


      Complications

      • Common complications of teratoma specially ovarian teratoma include:[1][2][3]
        • Torsion
        • Rupture
        • Malignant transformation
        • Infections
        • Autoimmune hemolytic anemia

      Prognosis

      • Mature teratoma has an excellent prognosis.[4]
      • The 6 year survival rate of patients with mature teratoma is approximately 96%.[5]
      • Immature teratoma has favorable prognosis for stage I and poor for advance stages.[6]
      • Immature teratoma has 90%-95% of 5 years of survival rate for stage I and 75 % for stage II-IV.[6]

      References

      1. ↑ Park SB, Kim JK, Kim KR, Cho KS (2008). “Imaging findings of complications and unusual manifestations of ovarian teratomas”. Radiographics. 28 (4): 969–83. doi:10.1148/rg.284075069. PMID 18635624.
      2. ↑ Comerci JT, Licciardi F, Bergh PA, Gregori C, Breen JL (1994) Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature. Obstet Gynecol 84 (1):22-8. PMID: 8008317
      3. ↑ Singh P, Yordan EL, Wilbanks GD, Miller AW, Wee A (1988). “Malignancy associated with benign cystic teratomas (dermoid cysts) of the ovary”. Singapore Med J. 29 (1): 30–4. PMID 2841767.
      4. ↑ Terenziani M, D’Angelo P, Inserra A, Boldrini R, Bisogno G, Babbo GL; et al. (2015). “Mature and immature teratoma: A report from the second Italian pediatric study”. Pediatr Blood Cancer. 62 (7): 1202–8. doi:10.1002/pbc.25423. PMID 25631333.
      5. ↑ Göbel U, Calaminus G, Engert J, Kaatsch P, Gadner H, Bökkerink JP; et al. (1998). “Teratomas in infancy and childhood”. Med Pediatr Oncol. 31 (1): 8–15. doi:10.1002/(sici)1096-911x(199807)31:1<8::aid-mpo2>3.0.co;2-h. PMID 9607423.
      6. ↑ 6.0 6.1 Mann JR, Gray ES, Thornton C, Raafat F, Robinson K, Collins GS et al. (2008) Mature and immature extracranial teratomas in children: the UK Children’s Cancer Study Group Experience. J Clin Oncol 26 (21):3590-7. DOI:10.1200/JCO.2008.16.0622 PMID: 18541896

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      Diagnosis

      Diagnosis

      History and Symptoms | Physical Examination | Staging | Laboratory Findings | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

      Treatment

      Treatment

      Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

      Case Study

      Case Study

      Case #1

      See also

      See also

      Tumor pages for locations in which teratoma can occur:

      Related Chapters

      Template:Tumors


      ar:ورم مسخي bg:Тератом de:Teratom ko:기형종 it:Teratoma he:טרטומה nl:Teratoom sv:Teratom


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