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Ovarian Teratoma
Sara M. O'Hara, MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Dermoid tumor, dermoid cyst, cystic teratoma
          • Definitions

            • Teratomas are made up of various parenchymal cell types from > 1 germ layer, usually all 3
            • Teratomas generally lie in midline or paraxial & arise from totipotential cells
            • Term dermoid comes from skin-like lining found in many of these tumors

          IMAGING

          • General Features

            • Radiographic Findings

              • Ultrasonographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      Selected References

                                      1. Billmire D et al: Imaging appearance of nongerminoma pediatric ovarian germ cell tumors does not discriminate benign from malignant histology. J Pediatr Adolesc Gynecol. 34(3):383-6, 2020
                                      2. Brind'Amour A et al: Recurrent high-grade ovarian immature teratoma with peritoneal dissemination. J Pediatr Adolesc Gynecol. 33(5):586-9, 2020
                                      3. Hanafy AK et al: Imaging in pediatric ovarian tumors. Abdom Radiol (NY). 45(2):520-36, 2020
                                      4. Imran H et al: Growing teratoma syndrome after chemotherapy for ovarian immature teratoma. J Pediatr Hematol Oncol. 42(7):e630-3, 2020
                                      5. Park C et al: Pediatric whole body MRI detects causative ovarian teratoma in opsoclonus myoclonus syndrome. Radiol Case Rep. 15(3):204-9, 2020
                                      6. Szymon O et al: Ovarian sparing surgery in mature ovarian teratomas in children: a 20-year single-center experience. Eur J Pediatr Surg. 31(1):2-7, 2020
                                      7. Lala SV et al: Ovarian neoplasms of childhood. Pediatr Radiol. 49(11):1463-75, 2019
                                      8. Faure-Conter C et al: Immature ovarian teratoma: when to give adjuvant therapy? J Pediatr Hematol Oncol. 39(7):487-9, 2017
                                      9. Gonzalez DO et al: Management of benign ovarian lesions in girls: a trend toward fewer oophorectomies. Curr Opin Obstet Gynecol. 29(5):289-94, 2017
                                      10. Pensabene M et al: An uncommon case of adolescent ovarian teratoma incarcerated in inguinal hernia. Case Rep Pediatr. 2016:4534053, 2016
                                      11. Hayes-Jordan A et al: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in pediatric ovarian tumors: a novel treatment approach. Pediatr Surg Int. 32(1):71-3, 2016
                                      12. Hsu MH et al: Paraneoplastic neurological disorders in children with benign ovarian tumors. Brain Dev. 36(3):248-53, 2014
                                      13. Salvucci A et al: Pediatric anti-NMDA (N-methyl D-aspartate) receptor encephalitis. Pediatr Neurol. 50(5):507-10, 2014
                                      14. Loh AH et al: Diagnostic accuracy of preoperative alpha-fetoprotein as an ovarian tumor marker in children and adolescents: not as good as we thought? Pediatr Surg Int. 29(7):709-13, 2013
                                      15. Chabaud-Williamson M et al: Ovarian-sparing surgery for ovarian teratoma in children. Pediatr Blood Cancer. 57(3):429-34, 2011
                                      16. Epelman M et al: Imaging of pediatric ovarian neoplasms. Pediatr Radiol. 41(9):1085-99, 2011
                                      17. Alotaibi MO et al: Imaging of ovarian teratomas in children: a 9-year review. Can Assoc Radiol J. 61(1):23-8, 2010
                                      18. Poloni C et al: Severe childhood encephalopathy with dyskinesia and prolonged cognitive disturbances: evidence for anti-N-methyl-D-aspartate receptor encephalitis. Dev Med Child Neurol. 52(5):e78-82, 2010
                                      19. De Nayer AR et al: A subacute behavioral disorder in a female adolescent. Autoimmune anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Biol Psychiatry. 66(6):e13-4, 2009
                                      20. Saba L et al: Mature and immature ovarian teratomas: CT, US and MR imaging characteristics. Eur J Radiol. 72(3):454-63, 2009
                                      21. Islam S et al: Management and outcomes of ovarian masses in children and adolescents. Am Surg. 74(11):1062-5, 2008
                                      22. Park SB et al: Imaging findings of complications and unusual manifestations of ovarian teratomas. Radiographics. 28(4):969-83, 2008
                                      23. Benoit MF et al: Recurrent mature cystic ovarian teratoma in adolescence: atypical case of the growing teratoma syndrome. Obstet Gynecol. 105(5 Pt 2):1264-6, 2005
                                      24. Lai CH et al: Outcome and prognostic factors in ovarian germ cell malignancies. Gynecol Oncol. 96(3):784-91, 2005
                                      25. Phupong V et al: Ovarian teratoma with diffused peritoneal reactions mimicking advanced ovarian malignancy. Arch Gynecol Obstet. 270(3):189-91, 2004
                                      26. Rha SE et al: Atypical CT and MRI manifestations of mature ovarian cystic teratomas. AJR Am J Roentgenol. 183(3):743-50, 2004
                                      27. Umesaki N et al: MR and ultrasound imaging of floating globules in mature ovarian cystic teratoma. Gynecol Obstet Invest. 58(3):130-2, 2004
                                      28. PDQ Pediatric Treatment Editorial Board: Childhood extracranial germ cell tumors treatment (PDQ®): Health Professional Version, 2002
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Synonyms

                                                • Dermoid tumor, dermoid cyst, cystic teratoma
                                              • Definitions

                                                • Teratomas are made up of various parenchymal cell types from > 1 germ layer, usually all 3
                                                • Teratomas generally lie in midline or paraxial & arise from totipotential cells
                                                • Term dermoid comes from skin-like lining found in many of these tumors

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • Ultrasonographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          Selected References

                                                                          1. Billmire D et al: Imaging appearance of nongerminoma pediatric ovarian germ cell tumors does not discriminate benign from malignant histology. J Pediatr Adolesc Gynecol. 34(3):383-6, 2020
                                                                          2. Brind'Amour A et al: Recurrent high-grade ovarian immature teratoma with peritoneal dissemination. J Pediatr Adolesc Gynecol. 33(5):586-9, 2020
                                                                          3. Hanafy AK et al: Imaging in pediatric ovarian tumors. Abdom Radiol (NY). 45(2):520-36, 2020
                                                                          4. Imran H et al: Growing teratoma syndrome after chemotherapy for ovarian immature teratoma. J Pediatr Hematol Oncol. 42(7):e630-3, 2020
                                                                          5. Park C et al: Pediatric whole body MRI detects causative ovarian teratoma in opsoclonus myoclonus syndrome. Radiol Case Rep. 15(3):204-9, 2020
                                                                          6. Szymon O et al: Ovarian sparing surgery in mature ovarian teratomas in children: a 20-year single-center experience. Eur J Pediatr Surg. 31(1):2-7, 2020
                                                                          7. Lala SV et al: Ovarian neoplasms of childhood. Pediatr Radiol. 49(11):1463-75, 2019
                                                                          8. Faure-Conter C et al: Immature ovarian teratoma: when to give adjuvant therapy? J Pediatr Hematol Oncol. 39(7):487-9, 2017
                                                                          9. Gonzalez DO et al: Management of benign ovarian lesions in girls: a trend toward fewer oophorectomies. Curr Opin Obstet Gynecol. 29(5):289-94, 2017
                                                                          10. Pensabene M et al: An uncommon case of adolescent ovarian teratoma incarcerated in inguinal hernia. Case Rep Pediatr. 2016:4534053, 2016
                                                                          11. Hayes-Jordan A et al: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in pediatric ovarian tumors: a novel treatment approach. Pediatr Surg Int. 32(1):71-3, 2016
                                                                          12. Hsu MH et al: Paraneoplastic neurological disorders in children with benign ovarian tumors. Brain Dev. 36(3):248-53, 2014
                                                                          13. Salvucci A et al: Pediatric anti-NMDA (N-methyl D-aspartate) receptor encephalitis. Pediatr Neurol. 50(5):507-10, 2014
                                                                          14. Loh AH et al: Diagnostic accuracy of preoperative alpha-fetoprotein as an ovarian tumor marker in children and adolescents: not as good as we thought? Pediatr Surg Int. 29(7):709-13, 2013
                                                                          15. Chabaud-Williamson M et al: Ovarian-sparing surgery for ovarian teratoma in children. Pediatr Blood Cancer. 57(3):429-34, 2011
                                                                          16. Epelman M et al: Imaging of pediatric ovarian neoplasms. Pediatr Radiol. 41(9):1085-99, 2011
                                                                          17. Alotaibi MO et al: Imaging of ovarian teratomas in children: a 9-year review. Can Assoc Radiol J. 61(1):23-8, 2010
                                                                          18. Poloni C et al: Severe childhood encephalopathy with dyskinesia and prolonged cognitive disturbances: evidence for anti-N-methyl-D-aspartate receptor encephalitis. Dev Med Child Neurol. 52(5):e78-82, 2010
                                                                          19. De Nayer AR et al: A subacute behavioral disorder in a female adolescent. Autoimmune anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Biol Psychiatry. 66(6):e13-4, 2009
                                                                          20. Saba L et al: Mature and immature ovarian teratomas: CT, US and MR imaging characteristics. Eur J Radiol. 72(3):454-63, 2009
                                                                          21. Islam S et al: Management and outcomes of ovarian masses in children and adolescents. Am Surg. 74(11):1062-5, 2008
                                                                          22. Park SB et al: Imaging findings of complications and unusual manifestations of ovarian teratomas. Radiographics. 28(4):969-83, 2008
                                                                          23. Benoit MF et al: Recurrent mature cystic ovarian teratoma in adolescence: atypical case of the growing teratoma syndrome. Obstet Gynecol. 105(5 Pt 2):1264-6, 2005
                                                                          24. Lai CH et al: Outcome and prognostic factors in ovarian germ cell malignancies. Gynecol Oncol. 96(3):784-91, 2005
                                                                          25. Phupong V et al: Ovarian teratoma with diffused peritoneal reactions mimicking advanced ovarian malignancy. Arch Gynecol Obstet. 270(3):189-91, 2004
                                                                          26. Rha SE et al: Atypical CT and MRI manifestations of mature ovarian cystic teratomas. AJR Am J Roentgenol. 183(3):743-50, 2004
                                                                          27. Umesaki N et al: MR and ultrasound imaging of floating globules in mature ovarian cystic teratoma. Gynecol Obstet Invest. 58(3):130-2, 2004
                                                                          28. PDQ Pediatric Treatment Editorial Board: Childhood extracranial germ cell tumors treatment (PDQ®): Health Professional Version, 2002