Health Encyclopedia

Malignant teratoma

Definition

Malignant teratoma is a type of cancer that involves cysts that contain one or more of the three main types of cells found in a developing baby (embryo). These cells are callled ectoderms, mesoderms, and endoderms.

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 mediastinum (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 about 42% will see long-term survival.

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:9/11/2006
Reviewed By:Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.

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