Teratomas also known as are most common germ cell neoplasm. Most,but not all, teratomas are benign.The component tissues in a teratoma range from immature to well differentiated, and are foreign to the anatomic site in which they are found.
Teratomas are divided into four categories: mature (cystic or solid,benign,immature (malignant),malignant due to a component of another somatic malignant neoplasm, and monodermal or highly specialised.
Mature cystic teratoma (DERMOID CYST) Most teratomas are cystic and composed of mature differentiated (adult); they are better known as dermoid cyst. The mature cystic teratoma account for more than 95 percent of all ovarian teratomas and is almost invariably benign. Dermoid cyst are the most common ovarian tumour in women in second and third decade of life.
HISTOPATHOLOGY: Mature cystic teratomas contain mature tissue of ectodermal(eg. Skin, hair follicles, sebaceous glands), mesodermal(eg, muscle ,urinary)and endodermal(eg lung and gastrointestinal).They are bilateral in 10 to 17 percent of cases.
Clinical manifestations: Most women with dermoid cysts are asymptomatic. If present, symtoms depend upon the size to the mass. Torsion is not uncommon. Rupture of dermoid cysts with spillage of sebaceous material into the abdominal cavity can occur, but is uncommon. Shock and hemorrhage are the immediate complications. A marked granulomatous reaction may subsequently develop and lead to formation of dense adhesions. A rare condition associated with either mature or immature teratomas is NMDA receptor encephalitis.
Diagonosis: These tumors have characteristics ultrasound appearance which allows reasonably accurate non invasive diagnosis in many cases. Definitive diagnosis is made at the time of surgical excision.
Treatment: ovarian cystectomy suggested in order to make a definitive diagnosis, preserve ovarian tissue and avoid potential problems such as torsion ,rupture or development of malignant components.. For women who has completed child bearing salphingoophorectomy is also acceptable treatment. Benign cystic teratomas don’t reoccur if surgically resected. Dermoid cyst may be removed via either laparoscopy or laparotomy. With Either approach abdomen should be copiously irrigated to avoid chemical peritonitis from spillage of the sebaceous cyst fluid.