Learning objectives
To discuss the wide range of age groups and anatomical locations which can be affected by teratoma
To identify the imaging characteristics of teratoma, with special focus on MRI
To distinguish the two main forms - mature and immature teratoma
Background
Teratomas are non-seminomatous germ cell tumors, which are composed of multiple cell types derived from one or more of the three germ layers, like endoderm, mesoderm, and ectoderm.
Pathophysiology
Numerous hypotheses exist about the origin of teratomas. They derive from totipotent cells normally found in the ovaries, testes, or midline embryonic remnants that sequestered under pathological conditions. They contain tissue elements that are foreign to the anatomical localization, from which they arise. Immature teratomas contain undifferentiated cells[1].
Epidemiology
It is the most common neonatal tumor,...
Findings and procedure details
Our poster presents MR imaging characteristics of histologically-validated mature and immature teratomas of different age groups found at different common and rare anatomic locations.
Teratomas identified duringfetallife: intracranial, intraorbital, cervical, sacrococcygeal locations.
Teratomas diagnosed in thepediatric and adultpopulation: sacrococcygeal, pelvic and ovarian locations.
Before elaborating on the MRI characteristics of teratomas, we briefly describe the features observed in other imaging modalities.
Plain radiograph
It shows non-specific calcification, which may be suspicious for the presence of mature teratoma. A calcified capsule or ectopic tooth may be...
Conclusion
Despite the relatively rare occurrence and the wide age ranges, the radiological appearance of teratomas is typical in most of the cases. Distinguishing mature and immature teratomas on MRI is difficult as there is no complete diagnostic criterion. Large, predominantly solid masses with increased serum ∝-fetoprotein levels may be associated with a greater likelihood.
References
1.Gonzalez-Crussi F (1982) Extragonadal Teratomas. Atlas of Tumor Pathology, Second Series, Fascicle 18.Armed Forces Institute of Pathology, Washington D.C.
2.Tapper D, Lack EE. Teratomas in infancy and childhood. A 54-year experience at the Children’s Hospital Medical Center. Ann Surg 1983; 198: 398–410.
3.Crussi FG, et al. Sacrococcygeal teratoma in infants and children. Arch Pathol Lab Med. 1978;102:402–405
4.Chung HW, et al. T2-Weighted fast MR imaging with true FISP versus HASTE: comparative efficacy in the evaluation of normal fetal brain maturation. AJR Am J Roentgenol. 2000...
