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Henigsman, DO — By Steph Coelho on July 14, 2022A teratoma is a rare type of germ cell tumor (GCT) that may contain different types of tissue. These tumors occur most commonly in the ovaries, testicles, and tailbone. However, they can occur elsewhere in the body. Teratomas are a type of GCT. This term refers to a tumor that develops from germ cells, which are the cells that develop into the cells that make up the male and female reproductive systems. This is why teratomas commonly occur in the testes and ovaries. However, germ cells can migrate to other parts of the body and develop into tumors known as extragonadal germ cell tumors. Teratomas can appear in newborns, children, or adults. They may be benign, meaning noncancerous, or malignant. The treatment plan for a teratoma will typically involve surgery. In this article, we discuss teratomas in more detail, including the symptoms, causes, diagnosis, and treatment of this type of tumor. A note about sex and gender Sex and gender exist on spectrums. This article will use the terms, “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. What is a teratoma Share on PinterestYellow Dog Productions/Getty ImagesA teratoma is a type of tumor that may contain many different tissues. Its name comes from the Greek for “monstrous tumor.” For example, it may contain:hairboneteethmuscleorgans These types of tumors often develop in the gonads, which is why the testicles and ovaries are common sites. However, they can occur elsewhere in the body, especially in midline locations. These are sites in the middle of the body, such as the head and spine. Common sites for teratomas can include:ovariestesteslower spinechestabdomenbrain and spinal cord Doctors typically classify teratomas into two subtypes: mature or immature. An immature teratoma looks very different than normal cells under a microscope and is usually malignant. In contrast, mature teratomas appear similar to normal cells and are usually benign. Both types may produce enzymes or hormones that can cause signs and symptoms of disease. Symptoms The symptoms of a teratoma can vary depending on the size and location of the tumor. In some cases, people with teratomas may not have any symptoms at all and only notice a mass when it becomes large enough to be noticeable. Possible symptoms include:a mass, swelling, or lump that a person can feel or seeconstipation or incontinenceleg weaknessabdominal paindifficulty breathing If a teratoma is hormone-secreting, it may cause noticeable symptoms in prepubescent children and can result in precocious puberty, which is the very early onset of puberty. These hormonal changes can occur in male or female children. Causes and risk factors At present, the exact cause of teratomas is unknown. However, they may have a link with inherited conditions that affect the central nervous system, genitourinary tract, and lower spine. Research suggests that teratomas occur due to changes in embryonic stem cells. These special cells are pluripotent, which means they are able to develop into any other cell in the body. During development, some of these cells may not differentiate, instead retaining the ability to turn into other cell types. This is why teratomas may feature many different body parts, such as bone, hair, or teeth, which are foreign to the location of the tumor. Risk factors may also vary depending on the type of teratoma. For example, research suggests that risk factors for testicular teratomas can include:low birth weight and small size at birthcryptorchidismhypospadiasmaternal bleedingadvanced maternal agejaundiceretained placenta Risk factors for ovarian teratomas becoming malignant may include:older agelarge tumor sizehaving gone through menopauseelevated levels of a protein called cancer antigen 125 (CA-125) Diagnosis In addition to taking a medical history and doing a physical exam, a doctor will likely use the following tests to help diagnose a teratoma:imaging, such as a CT scan or ultrasound, to locate a potential tumoralpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) blood tests, with elevated levels indicating the presence of a teratomacomplete blood count (CBC)liver, kidney, and lung function testsa biopsy of the mass Doctors may also accidentally discover a teratoma while performing tests to diagnose another illness or condition. After reaching a diagnosis, a doctor will also stage the cancer from 1 to 4. This classification refers to the size of the tumor and whether it has spread to other parts of the body. A stage 1 teratoma will be small and localized, but by stage 4, it will be larger and have spread to distant locations. Treatment In most cases, treatment for a teratoma will involve surgically removing the entire tumor. A person may also require chemotherapy after the surgery. The type of teratoma and whether it is malignant may also affect the treatment options. For example, with ovarian teratomas, the four standard treatments are:surgeryobservationchemotherapyradiation therapy For an individual with a stage 1 ovarian teratoma, surgery may be the only necessary treatment if the tumor is small and easy to remove. If a person requires chemotherapy, the American Cancer Society notes that doctors typically prescribe three cycles of chemotherapy on the PEB regimen. This chemotherapy regimen includes the drugs cisplatin, etoposide, and bleomycin. Summary A teratoma is a type of germ cell tumor that can be benign or cancerous. These tumors may contain several different types of tissue, such as hair, muscle, and bone. They usually occur in the ovaries in females, the testicles in males, and the tailbone in children. However, they can sometimes appear elsewhere in the body. The treatment varies depending on the tumor’s location, size, and stage, but it typically involves surgical removal and chemotherapy. Last medically reviewed on July 14, 2022Men's HealthCancer / OncologyWomen's Health / Gynecology 27 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Alwakid, I. H., et al. (2017). Giant mesenteric teratoma in a 6 month-old. https://www.sciencedirect.com/science/article/pii/S2213576617301562Anatomic terminology. (n.d.). https://training.seer.cancer.gov/anatomy/body/terminology.htmlEmbryonic stem cells: Where do they come from and what can they do?. (n.d.). https://www.eurostemcell.org/embryonic-stem-cells-where-do-they-come-and-what-can-they-doExtragonadal germ cell tumors - patient version. (n.d.). https://www.cancer.gov/types/extragonadal-germ-cellFarci, F., et al. (2022). Testicular teratoma. https://www.ncbi.nlm.nih.gov/books/NBK567728/Germ cell ovarian cancers. (2022). https://www.cancerresearchuk.org/about-cancer/ovarian-cancer/types/germ-cellGerm cell tumors. (n.d.). https://www.hopkinsmedicine.org/kimmel_cancer_center/cancers_we_treat/pediatric_oncology/becoming_our_patient/cancer_types/germ_cell_tumors.htmlLabel: Bleomycin injection, powder, lyophilized, for solution. (2022). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=905e0984-2ce3-481c-b1a0-0ef0a616479aLabel: Cisplatin injection. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b2b029f5-0d7e-4e7f-accc-b722aec34c68Label: Etoposide - etoposide injection, solution. (2022). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fe870629-104d-4d67-a7c6-f53bc588121e#:~:text=%2Ddemethylepipodophyllotoxin%20…-,Etoposide%20(also%20commonly%20known%20as%20VP%2D16)%20is%20a,%CE%B2%2DD%2Dglucopyranoside%5D.Mediastinal teratoma. (2019). https://www.nicklauschildrens.org/conditions/mediastinal-teratomaNCI dictionaries: Germ cell. (n.d.). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/germ-cellNCI dictionaries: Immature teratoma. (n.d.). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immature-teratomaNCI dictionaries: Mature teratoma. (n.d.). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/mature-teratomaNCI dictionaries: Teratoma. (n.d.). https://www.cancer.gov/publications/dictionaries/cancer-terms/def/teratomaNgoc, C. T. B., et al. (2015). Mixed embryonal carcinoma - teratoma cause early puberty: A case report. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428520/Ovarian germ cell tumors treatment (PDQ) - patient version. (2022). https://www.cancer.gov/types/ovarian/patient/ovarian-germ-cell-treatment-pdqPark, C.-H., et al. (2015). Risk factors for malignant transformation of mature cystic teratoma. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663225/Precocious puberty. (2016). https://rarediseases.org/rare-diseases/precocious-puberty/Rana, A. N., et al. (2020). Germ cell tumor presenting with precocious puberty in a girl in United Arab Emirates. https://www.karger.com/Article/Fulltext/505669Sacrococcygeal teratoma. (2022). https://www.nicklauschildrens.org/conditions/sacrococcygeal-teratomaTao, H., et al. (2018). Comparison of teratoma formation between embryonic stem cells and parthenogenetic embryonic stem cells by molecular imaging. https://www.hindawi.com/journals/sci/2018/7906531/Teratoma. (2022). https://www.nicklauschildrens.org/conditions/teratomaTeratoma. (n.d.). https://www.childrenshospital.org/conditions/teratomaTeratomas of the head and neck. (n.d.). https://www.chop.edu/conditions-diseases/teratomas-head-and-neckTreatment for germ cell tumors of the ovary. (2018). https://www.cancer.org/cancer/ovarian-cancer/treating/germ-cell-tumors.htmlWhat are germ cell tumours? (2022).https://www.cancerresearchuk.org/about-cancer/germ-cell-tumoursFEEDBACK:Medically reviewed by Stacy A. 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