What are the symptoms of immature ovarian teratoma?

I don’t know if you have ever heard of immature ovarian teratoma. Many researchers say that the cause of this disease is unclear and it is a malignant condition. Many people are very worried when they suffer from this disease, so we often suffer from excessive stress in our hearts, which is certainly not conducive to the stability of the disease. Next, I will share with you the symptoms of immature ovarian teratoma, because I hope everyone can keep calm and not worry too much.

1. Causes of disease

Ovarian immature teratoma is composed of mature and immature embryonic tissues from three germ layers. It may show that one germ layer is immature or incompletely differentiated, or it may show that (2 to 3 germ layers are immaturely differentiated). Mature and immature tissues are often intermixed.

2. Pathogenesis

1. The gross tumor is mostly a huge unilateral mass, and the contralateral ovary may be combined with a benign teratoma. The capsule is smooth but often adheres to surrounding tissues or is torn during surgery. The cross-section is mostly solid with some cystic areas; occasionally the tumour is predominantly cystic with solid areas in the cyst wall. The solid area is soft and delicate, with bleeding and necrosis, and is colorful. Sometimes bones, cartilage, hair or brain tissue can be seen; the cystic area is usually filled with serous, mucous or jelly-like substances.

2. Microscopically, it is composed of mature and immature tissues from three germ layers; the ectoderm is mainly composed of neural tissue and skin, the mesoderm is mainly composed of fibrous connective tissue, cartilage, bone, muscle and undifferentiated mesenchymal tissue, the endoderm is mainly glandular duct-like structure, and bronchial or gastrointestinal epithelium can sometimes be seen. These tissues were at various stages of maturation and had no organoid arrangement. Immature tissue mainly refers to neuroepithelial tissue, which can form rosettes or neural tube structures (Figure 1) or diffuse into sheets.

Based on the content of this neuroepithelium in the tumor, some scholars have proposed a grading method for immature teratomas. This classification is important for both treatment and prognosis.

Level 0: All are mature organizations.

Grade I: There is a small amount of immature tissue (mainly glial and primitive mesenchyme), and nuclear division can be seen. The neuroepithelium is sparse and limited to 1/40x field of view in each slice.

Grade II: There is a lot of immature tissue, but the neuroepithelium does not exceed 3/40x field of view in each section.

Stage III: There is a large amount of immature tissue, with the amount of neuroepithelium occupying 4 or more/40 times the field of view in each section, and it is often fused with sarcomatous stroma.

This pathological grading method has been widely used. Some scholars have also proposed that if the amount of neuroepithelium in each section is 10%, it is grade I, if it is 10% to 33%, it is grade II, and if it is more than 33%, it is grade III. In order to reduce the inconsistency of grading, Norris et al. recently proposed to merge this grading into two categories: low-grade malignancy and high-grade malignancy, namely grade I that does not require chemotherapy and grades II and III that require postoperative chemotherapy. These grading methods must be based on sufficient sampling, and one piece of sample should be obtained for every centimeter of the maximum diameter of the tumor in areas with different macroscopic morphology. If the tumor is >20cm, at least 20 pieces of tissue should be examined.

The morphology and tissue grade of metastases may differ from those of the primary tumor. In some cases, many nodules of varying sizes form on the surface of the peritoneum, which appear as well-differentiated glial cells under a light microscope. This condition is called peritoneal gliomatosis. This type of implant nodule is benign and will regress on its own after resection of the primary tumor.

The above content is what the editor shared with you about immature ovarian teratoma. You should pay special attention to this condition. If there is a more serious situation, you should seek help from a doctor. Because we don’t know the cause yet, we can’t easily draw conclusions. Our body is what we need to protect the most now. Only with a good body can we be happy every day. If we suffer from this disease, we don’t have to worry, because today’s medicine is more developed and there are mostly treatment methods.