Ovarian and non-ovarian teratomas: a wide spectrum of features
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INVITED REVIEW
Ovarian and non‑ovarian teratomas: a wide spectrum of features Tsukasa Saida1 · Kensaku Mori1 · Tomohiko Masumoto1 · Sodai Hoshiai1 · Toshitaka Ishiguro1 · Masafumi Sakai1 · Tadashi Hara1 · Hiroyuki Ochi2 · Toyomi Satoh2 · Manabu Minami1 Received: 7 May 2020 / Accepted: 20 August 2020 © Japan Radiological Society 2020
Abstract Teratoma is a germ cell tumor (GCT) derived from stem cells of the early embryo and the germ line. Teratoma is the most common neoplasm of the ovaries and is usually diagnosed easily using imagings by detecting fat components. However, there are various histopathological types and the imaging findings differ according to the type. Teratoma usually occurs in the gonads or in the midline due to migration of primordial germ cells during development. The clinical course of teratomas depends on the age of the patient, histological type, and anatomical site. Sometimes teratomas show unusual manifestations, such as mature teratoma without demonstrable fat components, torsion, rupture, growing teratoma syndrome, anti-N-methylD-aspartate receptor encephalitis, and autoimmune hemolytic anemia. For all of these reasons, teratomas demonstrate a wide spectrum of imaging features and radiologists should be familiar with these variabilities. The present article aims to introduce a model encompassing types of GCTs based on their developmental potential, and to review several histopathological types in various anatomical sites and unusual manifestations of teratomas, with representative imaging findings. Keywords Dermoid cyst · Gonadal · Extragonadal · Unusual · MRI · Magnetic resonance imaging
Introduction Teratoma is a germ cell tumor (GCT) derived from stem cells of the early embryo and the germ line [1]. The word “teratoma” is derived from the Greek word “terato,” which means monster [2]. There are several different histopathological types of teratomas, and their imaging findings also vary. Teratomas usually occur in the gonads, namely the ovaries in women and the testicles in men. They occur also in extragonadal sites, where migrating primordial germ cells are located during embryogenesis [3]. The clinical course of teratomas depends on age of the patient, histological type, and anatomical site [4]. For example, majority of the teratomas occur in the ovaries in adults and usually are mature
* Tsukasa Saida [email protected] 1
Department of Radiology, Faculty of Medicine, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki 305‑8575, Japan
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki 305‑8575, Japan
2
teratomas (MTs). On the other hand, the sacrococcygeal region is the most common site in pediatric patients, and the frequency of immature teratomas is relatively high. The developmental potential of GCTs characteristics is determined by the maturation stage and imprinting status of the originating germ cell. The recent progress in understanding GCT biology supports a comprehensive devel
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