Malignant teratoma

Definition:

Malignant teratoma is a type of cancer consisting of cysts that contain one or more of the three main types of cells present in embryos -- ectoderm, mesoderm, and endoderm cells.

Alternative Names:

Dermoid cyst - malignant; Nonseminomatous germ cell tumor - teratoma; Immature teratoma

Causes, incidence, and risk factors:

Malignant teratoma occurs most often in young men in their 20's - 30's. It is often located in the anterior mediastinum (in the chest). Most malignant teratomas have spread (metastasized) by the time of diagnosis and they can spread throughout the body.

A number of other cancers are often associated with these tumors including:

Acute myelogenous leukemia (AML)
Myelodysplasia (MDS)
Malignant histiocytosis
Embryonal rhabdomyosarcoma
Small cell undifferentiated carcinoma

Symptoms:

Symptoms result from spread of the tumor into surrounding tissues and include:

Cough
Shortness of breath
Chest pain
Limited exercise tolerance
Fatigue

Signs and tests:

On physical examination, a physician may see signs of congestive heart failure and increased pressure in the chest cavity. Diagnosis is made using the following tests:

History and physical examination
CT scans of the chest, abdomen, and pelvis
Elevated levels of b-HCG and AFP in the blood
Mediastinoscopy and biopsy -- use of a special scope to look in the mediastinuman (mediastinoscopy) and remove a piece of the tumor (biopsy)
Anterior mediastinotomy -- open surgery to remove the tumor or part of it

Treatment:

Because malignant teratomas have often spread by the time of diagnosis, anticancer chemotherapy is usually needed. Cisplatin, etoposide, and bleomycin are commonly used as a combination of chemotherapy.

After chemotherapy is complete, CT scans are repeated. If there is a residual mass in the area of the tumor, surgery is recommended because of the possibility that the cancer will grow back in that area.

Support Groups:

There are many support groups available for people with cancer. Contact the American Cancer Society or search the Internet to find one near you. Research has shown that women with breast cancer survive longer if they participate in a support group and the same may be true for other cancers.

Expectations (prognosis):

The prognosis for people with malignant teratomas is based on the size of the tumor, its location, and the age of the patient. In young patients, less than 15 years of age, teratomas are more likely to be benign. For adults, complete remission is possible in 50-70% of patients and long-term survival is seen in about 42%.

Complications:

The cancer can spread throughout the body and there may be complications of surgery or related to chemotherapy.

Calling your health care provider:

Call your health care provider if you have symptoms suggestive of malignant teratoma.

Review Date: 8/8/2002
Reviewed By: Scott Howard, M.D., M.S., Memphis, TN. Review provided by VeriMed Healthcare Network.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2003 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.