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Pediatrics
Diagnosis
Pediatric Neuroradiology
Brain
Pathology-Based Diagnoses
Neoplasms
Germ Cell Tumors
Teratoma
Teratoma
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Teratoma: Nongerminomatous germ cell tumor
                • Arises from multipotential germ cells
                • Tridermic (contains tissues derived from all 3 germ cell layers)
              • Types
                • Mature teratoma (most common; well differentiated)
                • Immature teratoma (some incompletely differentiated tissue)
                • Teratoma with malignant transformation

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Abdelmuhdi AS et al: Intracranial teratoma: imaging, intraoperative, and pathologic features: AIRP best cases in radiologic-pathologic correlation. Radiographics. 37(5):1506-11, 2017
                                            2. Lagman C et al: Teratomas of the cranial vault: a systematic analysis of clinical outcomes stratified by histopathological subtypes. Acta Neurochir (Wien). 159(3):423-33, 2017
                                            3. Robles Fradejas M et al: Fetal intracranial immature teratoma: presentation of a case and a systematic review of the literature. J Matern Fetal Neonatal Med. 1-8, 2016
                                            4. Zygourakis CC et al: Management of central nervous system teratoma. J Clin Neurosci. 22(1):98-104, 2015
                                            5. Kralik SF et al: Diffusion imaging for tumor grading of supratentorial brain tumors in the first year of life. AJNR Am J Neuroradiol. 35(4):815-23, 2014
                                            6. Bohara M et al: Mature posterior fossa teratoma mimicking dermoid cyst. Brain Tumor Pathol. 30(4):262-5, 2013
                                            7. Ghosal N et al: Posterior third ventricular mature teratoma with a hemangiomatous component. Clin Neuropathol. 32(6):532-5, 2013
                                            8. Goyal N et al: Intracranial teratomas in children: a clinicopathological study. Childs Nerv Syst. 29(11):2035-42, 2013
                                            9. Liu Z et al: Imaging characteristics of primary intracranial teratoma. Acta Radiol. 55(7):874-81, 2013
                                            10. Sanyal P et al: A case of mature cystic teratoma arising from the fourth ventricle. Case Rep Pathol. 2013:702424, 2013
                                            11. Sweiss RB et al: Suprasellar mature cystic teratoma: an unusual location for an uncommon tumor. Case Rep Neurol Med. 2013:180497, 2013
                                            12. Taniguchi M et al: A rapidly expanding immature teratoma originating from a neurohypophyseal germinoma. Neuropathol Appl Neurobiol. 39(4):445-8, 2013
                                            13. Goyal N et al: Mature teratoma in association with neural tube defect (occipital encephalocele): series of four cases and review of the literature. Pediatr Neurosurg. 48(2):67-72, 2012
                                            14. Isaacs H: Fetal brain tumors: a review of 154 cases. Am J Perinatol. 26(6):453-66, 2009
                                            15. Sato K et al: Pathology of intracranial germ cell tumors. Prog Neurol Surg. 23:59-75, 2009
                                            16. Berhouma M et al: Transcortical approach to a huge pineal mature teratoma. Pediatr Neurosurg. 44(1):52-4, 2008
                                            17. Köken G et al: Prenatal diagnosis of a fetal intracranial immature teratoma. Fetal Diagn Ther. 24(4):368-71, 2008
                                            18. Noudel R et al: Intracranial teratomas in children: the role and timing of surgical removal. J Neurosurg Pediatr. 2(5):331-8, 2008
                                            19. Arslan E et al: Massive congenital intracranial immature teratoma of the lateral ventricle with retro-orbital extension: a case report and review of the literature. Pediatr Neurosurg. 43(4):338-42, 2007
                                            20. Erman T et al: Congenital intracranial immature teratoma of the lateral ventricle: a case report and review of the literature. Neurol Res. 27(1):53-6, 2005
                                            21. Cavalheiro S et al: Fetal brain tumors. Childs Nerv Syst. 19(7-8):529-36, 2003
                                            22. Jaing TH et al: Intracranial germ cell tumors: a retrospective study of 44 children. Pediatr Neurol. 26(5):369-73, 2002
                                            23. Liang L et al: MRI of intracranial germ-cell tumours. Neuroradiology. 44(5):382-8, 2002
                                            24. Okada Y et al: Hypomethylated X chromosome gain and rare isochromosome 12p in diverse intracranial germ cell tumors. J Neuropathol Exp Neurol. 61(6):531-8, 2002
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Definitions

                                                        • Teratoma: Nongerminomatous germ cell tumor
                                                          • Arises from multipotential germ cells
                                                          • Tridermic (contains tissues derived from all 3 germ cell layers)
                                                        • Types
                                                          • Mature teratoma (most common; well differentiated)
                                                          • Immature teratoma (some incompletely differentiated tissue)
                                                          • Teratoma with malignant transformation

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Abdelmuhdi AS et al: Intracranial teratoma: imaging, intraoperative, and pathologic features: AIRP best cases in radiologic-pathologic correlation. Radiographics. 37(5):1506-11, 2017
                                                                                      2. Lagman C et al: Teratomas of the cranial vault: a systematic analysis of clinical outcomes stratified by histopathological subtypes. Acta Neurochir (Wien). 159(3):423-33, 2017
                                                                                      3. Robles Fradejas M et al: Fetal intracranial immature teratoma: presentation of a case and a systematic review of the literature. J Matern Fetal Neonatal Med. 1-8, 2016
                                                                                      4. Zygourakis CC et al: Management of central nervous system teratoma. J Clin Neurosci. 22(1):98-104, 2015
                                                                                      5. Kralik SF et al: Diffusion imaging for tumor grading of supratentorial brain tumors in the first year of life. AJNR Am J Neuroradiol. 35(4):815-23, 2014
                                                                                      6. Bohara M et al: Mature posterior fossa teratoma mimicking dermoid cyst. Brain Tumor Pathol. 30(4):262-5, 2013
                                                                                      7. Ghosal N et al: Posterior third ventricular mature teratoma with a hemangiomatous component. Clin Neuropathol. 32(6):532-5, 2013
                                                                                      8. Goyal N et al: Intracranial teratomas in children: a clinicopathological study. Childs Nerv Syst. 29(11):2035-42, 2013
                                                                                      9. Liu Z et al: Imaging characteristics of primary intracranial teratoma. Acta Radiol. 55(7):874-81, 2013
                                                                                      10. Sanyal P et al: A case of mature cystic teratoma arising from the fourth ventricle. Case Rep Pathol. 2013:702424, 2013
                                                                                      11. Sweiss RB et al: Suprasellar mature cystic teratoma: an unusual location for an uncommon tumor. Case Rep Neurol Med. 2013:180497, 2013
                                                                                      12. Taniguchi M et al: A rapidly expanding immature teratoma originating from a neurohypophyseal germinoma. Neuropathol Appl Neurobiol. 39(4):445-8, 2013
                                                                                      13. Goyal N et al: Mature teratoma in association with neural tube defect (occipital encephalocele): series of four cases and review of the literature. Pediatr Neurosurg. 48(2):67-72, 2012
                                                                                      14. Isaacs H: Fetal brain tumors: a review of 154 cases. Am J Perinatol. 26(6):453-66, 2009
                                                                                      15. Sato K et al: Pathology of intracranial germ cell tumors. Prog Neurol Surg. 23:59-75, 2009
                                                                                      16. Berhouma M et al: Transcortical approach to a huge pineal mature teratoma. Pediatr Neurosurg. 44(1):52-4, 2008
                                                                                      17. Köken G et al: Prenatal diagnosis of a fetal intracranial immature teratoma. Fetal Diagn Ther. 24(4):368-71, 2008
                                                                                      18. Noudel R et al: Intracranial teratomas in children: the role and timing of surgical removal. J Neurosurg Pediatr. 2(5):331-8, 2008
                                                                                      19. Arslan E et al: Massive congenital intracranial immature teratoma of the lateral ventricle with retro-orbital extension: a case report and review of the literature. Pediatr Neurosurg. 43(4):338-42, 2007
                                                                                      20. Erman T et al: Congenital intracranial immature teratoma of the lateral ventricle: a case report and review of the literature. Neurol Res. 27(1):53-6, 2005
                                                                                      21. Cavalheiro S et al: Fetal brain tumors. Childs Nerv Syst. 19(7-8):529-36, 2003
                                                                                      22. Jaing TH et al: Intracranial germ cell tumors: a retrospective study of 44 children. Pediatr Neurol. 26(5):369-73, 2002
                                                                                      23. Liang L et al: MRI of intracranial germ-cell tumours. Neuroradiology. 44(5):382-8, 2002
                                                                                      24. Okada Y et al: Hypomethylated X chromosome gain and rare isochromosome 12p in diverse intracranial germ cell tumors. J Neuropathol Exp Neurol. 61(6):531-8, 2002